No abstract

Among the group who had hypoperfusion, 94.4% were post cardiac surgery, of which 84.9% had cyanotic congenital heart disease. Treatment with peritoneal dialysis occurred in intensive care unit in 93.8% of the patients. It is associated with mechanical ventilation in 92.1%, use of two or more inotropes in 85.3% and two or more organ dysfunction in 71.2%. The indications for peritoneal dialysis were fluid overload(60.5%), uraemia and fluid overload(26.6%), uraemia(11.9%) and others(1.7%). Technique failure occurred in 1.1% of the patients and they were switched to haemodialysis. Mortality in our PD cohort was 30.5%. Age, weight, gender and primary aetiology of AKI were not significant risk factors of death. At hospital discharge, mean serum creatinine was 47.6(CI 34.3-60.9)mcmol/ L and estimated glomerular filtration rate(eGFR) was 89.7(CI 78.5-100.9) mls/min/1.73m 2. 10% of the patients had eGFR less than 60mls/min/m 2. None of the survivors developed end stage renal failure at hospital discharge. Conclusions: PD offers good patient survival and renal outcome as evidenced in our cohort. Hence, PD is a viable first line renal replacement therapy in severe AKI for young children with low body weight even if they are critically ill.

Introduction: Patients on hemodialysis (HD) or peritoneal dialysis (PD) were consistently reported to have a high prevalence of vitamin D deficiency. However, there are limited data among Asian population. Objective: To assess the prevalence of Serum 25(OH)-vitamin D deficiency in patients on maintenance HD and PD in Sarawak General Hospital. Methods: This cross sectional study was conducted from November 2015 to September 2016. Patients were classified as vitamin D deficient (<20 ng/ml), insufficient (21 and 29 ng/ml) or sufficient (>30 ng/ml). Results: Of the 170 patients, 101 were on HD and 69 were on CAPD. In HD patients, vitamin D deficiency was found in 7.9% of the patients (n ¼ 8), and insufficiency in 22.8% (n ¼ 23). In CAPD patients, vitamin D deficiency was found in 49.3% of the patients (n ¼ 34), and insufficiency in 30.4% (n ¼ 21).Among HD patients, those with serum 25(OH)D concentrations of <30 ng/ml were predominantly female (p¼ 0.000) and diabetic (p¼0.003). There were significant correlation between serum 25(OH)D and body mass index (p ¼ 0.026), waist circumference (p ¼ 0.031), dialysis vintage (p ¼ 0.005), and magnesium (p ¼ 0.001). There was no correlation with age, corrected calcium, albumin, phosphate, alkaline phosphatase, or intact parathyroid hormone level.Among PD patients, those with serum 25(OH)D concentrations of <30 ng/ml were predominantly female (p¼ 0.004), Malay race (p ¼0.000), urban locality (P ¼0.013) and diabetic (p¼0.000). There was no significant correlation with all the other demographic or laboratory parameters. Conclusions: Our study showed that vitamin D deficiency/insufficiency is highly prevalent among PD patients. However, the majority of our HD patients are not vitamin D deficient. Other risk factors identified include diabetes, female gender, and urban locality. Interestingly, the prevalence of vitamin D deficiency is very low among the Bidayuh patients. Further studies are needed to explore the reason for this and also the consequences of vitamin D deficiency and possible therapeutic interventions.