Peritoneal dialysis for children with acute kidney injury in Lagos, Nigeria: experience with adaptations

Abstract

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Introduction: International professional groups are supporting the training of physicians in developing countries in nephrology, including peritoneal dialysis (PD). This report documents the impact of such efforts in the provision of manual PD for children with acute kidney injury (AKI) in a public hospital in Lagos, Nigeria. ♦

Methods: Medical records of all children with AKI managed with PD between July 2010 and March 2013 were reviewed. ♦

Results: Seventeen children with a mean (SEM) age of 3.8 (0.8) years received PD for 0 - 18 days; about half were infants. PD was provided manually, frequently with intercostal drains as catheters. Blockage of catheters and peritonitis occurred in 4 (23.5%) and 2 (11.8%) children, respectively. Eight (47.1%) of the 17 children had resolution of AKI and were discharged from hospital. In 4 (57.1%) of the 7 children who died, PD was performed for ≤ 2 days. ♦

Conclusion: PD for childhood AKI is feasible in resource-constrained regions with fairly good outcome. Blockage of catheter was the most common complication encountered.

Keywords: Acute kidney injury; catheter blockage; catheters; peritoneal dialysis; peritonitis; sepsis.

FIGURE 1 —

Intercostal drain, dilator, guide wire and a 3-way tap.

FIGURE 2 —

Intercostal drain inserted for peritoneal dialysis.