Managing acute kidney injury in a child with improvised peritoneal dialysis in Kano, Nigeria

Obiagwu, Patience Ngozi; Gwarzo, Garba Dayyabu; Akhiwu, Helen Oluwadamilola; Wada, Aminu

doi:10.4103/0331-8540.108472

Cited by 10 publications

(9 citation statements)

References 1 publication

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“…Our patient had kwashiorkor and developed acute kidney injury, and he was treated with improvised PD as a modality of renal replacement therapy, which led to a good outcome. A similar approach was reported by Obiagwu et al in a child with acute kidney injury in Kano, Nigeria [11]. This shows that a patient with kwashiorkor who develops acute kidney injury may benefit from renal replacement therapy in the form of PD.…”

Section: Discussionsupporting

confidence: 54%

Improvised peritoneal dialysis in an 18-month-old child with severe acute malnutrition (kwashiorkor) and acute kidney injury: a case report

Fredrick

Valentine

2013

J Med Case Reports

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IntroductionSevere acute malnutrition is common in developing countries. Children with severe acute malnutrition are prone to complications, including electrolyte imbalance and infections. Our patient was an 18-month-old boy who had severe acute malnutrition (kwashiorkor) and developed acute kidney injury, which was managed with peritoneal dialysis using improvised equipment. This case report illustrates the importance of improvisation in resource-limited settings in providing lifesaving treatment. To the best of our knowledge, this is the first case report on peritoneal dialysis in a child with severe acute malnutrition (kwashiorkor).Case presentationWe report a case of an 18-month-old Bantu-African Tanzanian boy who had severe malnutrition and developed anuric acute kidney injury. He had severe renal dysfunction and was managed with peritoneal dialysis using an improvised catheter and bedside constituted fluids (from intravenous fluids) and was diuretic after 7 days of peritoneal dialysis, with complete recovery of renal functions after 2 weeks.ConclusionChildren with severe acute malnutrition who develop acute kidney injury should be offered peritoneal dialysis, which may be provided using improvised equipment in resource-limited settings, as illustrated in this case report.

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Section: Discussionsupporting

confidence: 54%

Improvised peritoneal dialysis in an 18-month-old child with severe acute malnutrition (kwashiorkor) and acute kidney injury: a case report

Fredrick

Valentine

2013

J Med Case Reports

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“…It is the most feared complication of PD and occurrence increases with duration of PD, use of constituted dialysates and poor observance of aseptic procedure. More so, PD is done manually by the bedside open ward in most centres in the country with [3][4][5][6][7][8][9] difficulty in maintaining aseptic environment. Ours is one of the lowest figures compared to all other Nigerian studies 4, 5, 8-10 so far.…”

Section: Discussionmentioning

confidence: 99%

“…The third technique in form of continuous RRT is for acute dialysis in the intensive care setting and can be used in haemodynamically 2 unstable patients. In developing countries associated with poor-resource setting, peritoneal dialysis is most practised in children because it is cost effective and some PD items can be improvised especially [3][4][5][6][7][8] catheter and dialysate fluids. This is unlike intermittent haemodialysis which is expensive and items needed not easily available in sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

Paediatric Acute Peritoneal Dialysis in Sokoto: Review and Outcome

Pk¹,

Fb²

2021

CMJ

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Background: Renal replacement therapy (RRT) in form of peritoneal dialysis (PD) is an important treatment procedure in Paediatric Acute Kidney Injury (AKI) management. It is cost effective and materials are easily sourced for in the developing countries. There is paucity of sub-Saharan Africa data on the use of PD in paediatric AKI, hence this study. Methods: This was a retrospective and descriptive study of cohort of children who were admitted into Emergency Paediatrics Unit of Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, and had PD done between July 1st, 2007 and July 31st, 2019. Age, gender, cause of AKI, indication for dialysis, type of dialysis fluid and peritoneal access used, duration, complication and outcome were documented. Results: A total number of 11 children who had acute PD due to AKI during the duration were studied with male preponderance of 8 (72.7%) and majority (81.8%) belonging to lower social class (IV and V). Their ages ranged between 5 months and 12 years with a mean age of 4.8±3 years. Acute glomerulonephritis (AGN) (n = 5), severe acute diarrhoeal disease (n = 4) and obstructive nephropathy (n =2) were causes of AKI. Peritoneal dialysis was performed manually using percutaneous commercial PD catheters (n=10) and adapted catheter (n=1). Duration of PD ranged from 3 to 17 days (mean: 8.1±4.1 days). The main complications were peri-catheter leakage (n = 6), and catheter obstruction (n = 3), exit wound (n=2) and acute bacterial peritonitis (n = 1). Of the 11 patients, 7 (63.6%) were discharged home alive and well, 3 (27.4%) died and 1(9.1%) left against medical advice. Conclusion: With meticulous attention to aseptic procedure and use of improvised dialysis fluids and catheters or semi-rigid PD catheters where available, PD is an affordable choice of RRT in management of paediatric AKI. Complications are bound to occur and are better anticipated and planned for.

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“…This, alongside the prohibitive costs of consumables, leads to the use of improvised methods and materials for dialysis as reported previously from this centre (Obiagwu et al . ) and others in Ghana and Tanzania (Antwi ; Frederick & Valentine ) The use of locally manufactured fluids is associated with lower costs of PD (Arogundade et al . ).…”

Section: Discussionmentioning

confidence: 99%

Peritoneal dialysis vs. haemodialysis in the management of paediatric acute kidney injury in Kano, Nigeria: a cost analysis

Obiagwu

Abdu

2014

Tropical Med Int Health

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Abstractobjective To determine the cost of the dialytic management of paediatric acute kidney injury in a low-income country.methods All children under the age of 15 years, who had either peritoneal dialysis or haemodialysis for acute kidney injury in Aminu Kano Teaching Hospital over a 1-year period, were studied. The average cost of each dialysis modality was estimated.results Of 20 children, who had dialysis for acute kidney injury, 12 (60%) had haemodialysis and 8 (40%) had peritoneal dialysis. The mean cost for haemodialysis exceeded that of peritoneal dialysis ($363.33 vs. $311.66, t = 1.04, P = 0.313) with the mean cost of consumables significantly accounting for most of the cost variation ($248.49 vs. $164.73, t = 2.91, P = 0.009). Mean costs of nephrologist visit and nursing were not found to be significant.conclusion Peritoneal dialysis is the less costly alternative for managing acute kidney injury in children in our environment.

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Managing acute kidney injury in a child with improvised peritoneal dialysis in Kano, Nigeria

Cited by 10 publications

References 1 publication

Improvised peritoneal dialysis in an 18-month-old child with severe acute malnutrition (kwashiorkor) and acute kidney injury: a case report

Improvised peritoneal dialysis in an 18-month-old child with severe acute malnutrition (kwashiorkor) and acute kidney injury: a case report

Paediatric Acute Peritoneal Dialysis in Sokoto: Review and Outcome

Peritoneal dialysis vs. haemodialysis in the management of paediatric acute kidney injury in Kano, Nigeria: a cost analysis

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