Continuous ambulatory peritoneal dialysis (CAPD) in children: a successful case for a bright future in a developing country

Abstract

The authors report the first case of successful peritoneal dialysis (PD) in a developing country performed about a 13-year-old adolescent followed-up for stage V chronic kidney disease (CKD) with anuria. After 3 months of hemodialysis, the parents opted for continuous ambulatory peritoneal dialysis (CAPD) as they wished to return home located 121km from Dakar. After PD catheter insertion, the plan proposed to the patient consisted 3-4 hours stasis of isotonic dialysate during the day and a night stasis of 8 hours of icodextrin for an injection volume of 1L per session. The patient and his mother were trained and assessed on the PD technique. After dialysis adequacy was tested while hospitalised, they were able to return home and continued the sessions following the same plan prescribed and while keeping in touch, by telephone, with the medical team. The technique assessment at the day hospital every 2 weeks revealed dialysis adequacy and satisfactory tolerance of PD at home after 04 months of observation. It was the first case of successful CAPD in the pediatrics unit in this context. Scaling this technique is a challenge for the pediatric nephrologist in developing countries like Senegal.

Keywords: Peritoneal dialysis; Senegal; child; developing countries.

Figure 1

Focal and segmental glomerulosclerosis (FSGS): fibrohyaline segmental glomerular lesions surrounded by dysmorphic podocytes Masson’s trichrome x 250

Figure 2

A) surgical insertion of TENCKOFF catheter; B) control ASP showing the catheter in a good position in the pouch of Douglas; C) the patient and his mother after the drainage; D) catheter migration in the right lumbar region