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. 2022 Dec;22(4):679-685.
doi: 10.4314/ahs.v22i4.74.

The effectiveness of locally-prepared peritoneal dialysate in the management of children with acute kidney injury in a south-east Nigerian tertiary hospital

Ngozi R Mbanefo  1 , Samuel N Uwaezuoke  1 , Ugo N Chikani  1 , Ada I Bisi-Onyemaechi  1 , Uzoamaka V Muoneke  1 , Odutola I Odetunde  1 , Henrietta U Okafor  1
Affiliations

The effectiveness of locally-prepared peritoneal dialysate in the management of children with acute kidney injury in a south-east Nigerian tertiary hospital

Ngozi R Mbanefo et al. Afr Health Sci. 2022 Dec.

Abstract

Background: Peritoneal dialysis (PD) is the preferred mode of renal replacement therapy (RRT) in children with acute kidney injury (AKI). The gold standard remains the use of commercially-prepared PD fluid. In resource-poor nations, its availability and affordability remain a challenge.

Aim: This study aims to report the effectiveness of locally-prepared PD fluid in the management of AKI in a south-east Nigerian tertiary hospital.

Subjects and methods: This was a retrospective study conducted at the paediatric ward of the University of Nigeria Teaching hospital, Enugu. The case records of 36 children seen over three years, diagnosed with AKI and requiring PD were reviewed. The retrieved information comprised biodata, aetiology of AKI, indications for PD, pre-and post-dialysis estimated glomerular filtration rate (eGFR) and patient outcomes.

Results: The children (20 males and 16 females) were aged 3 to 36 months with a mean age of 9.92 ± 6.29 months. The common aetiologies of AKI were septicemia (30.6%), hemolytic uremic syndrome (19.4%), and toxic nephropathy (16.7%). The frequent indications for PD were uremic encephalopathy (58.3%) and severe metabolic acidosis (38.8%). The pre-and post-dialysis mean urine flow rate was 0.16 + 0.13 and 2.77 + 0.56 ml/kg/hour respectively. The eGFR before PD, at discontinuation, and a week later was 6.06 + 2.87, 24.44 + 15.71 and 59.07 + 22.22 mls/min/1.73m2 respectively.

Conclusion: PD with locally-prepared dialysate is safe, effective and a life-saving alternative in the management of AKI in children.

Keywords: Peritoneal dialysis; acute kidney injury; children; developing country; dialysate; renal replacement therapy.

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References

    1. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL. Epidemiology of acute kidney injury in critically-ill children and young adults. N Engl J Med. 2017;376:11–20. - PMC - PubMed
    1. Alkandari O, Eddington KA, Hyder A, et al. Acute kidney injury is an independent risk factor for pediatric intensive care unit mortality, longer length of stay and prolonged mechanical ventilation in critically ill children: a two-center retrospective cohort study. Crit Care. 2011;15:146. - PMC - PubMed
    1. Vasudevan A, Iyengar A, Phadke K. Modality of choice for renal replacement therapy for children with acute kidney injury: Results of a survey. Indian J Nephrol. 2012;22(2):121–24. - PMC - PubMed
    1. Smoyer WE, Finkelstein FO, McCulloch M, et al. Saving young lives: provision of acute dialysis in low-resource settings. Lancet. 2015;386(10008):2056. - PubMed
    1. National Bureau of Statistics, author. 2019 Poverty and Inequality in Nigeria. https://nigerianstat.gov.ng .

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