Related Experiment Video
Updated: Dec 6, 2025
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
Long-term survival of children following acute peritoneal dialysis in a resource-limited setting
Michael Abel Alao1, Olayinka Rasheed Ibrahim2, Adanze Onyenonachi Asinobi3
1Department of Paediatrics, Bowen University Teaching Hospital, Nigeria & Bowen University College of Medicine, Ogbomosho, Nigeria.
Insights
Outcomes for children undergoing acute peritoneal dialysis (PD) in resource-limited settings are poor, with over half of survivors progressing to chronic kidney disease (CKD). Younger children, under age 5, had a better chance of survival after PD treatment.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Global Health
Background:
- Limited data exists on the long-term outcomes of children treated with acute peritoneal dialysis (PD) in resource-limited environments.
- Acute kidney injury (AKI) in children necessitates effective management strategies, especially in settings with constrained resources.
Purpose of the Study:
- To evaluate the long-term outcomes of children who underwent acute PD in a resource-limited setting.
- To assess survival rates, factors influencing survival, and the progression to chronic kidney disease (CKD) after acute PD.
Main Methods:
- A prospective cohort study was conducted involving children diagnosed with AKI according to the 2012 Kidney Disease: Improving Global Outcomes for children undergoing PD.
- Outcomes assessed included in-hospital mortality, 18-month survival post-dialysis, and progression to CKD.
- Kaplan-Meier survival analysis was used to determine 18-month survival rates.
Main Results:
- Twenty-nine children (median age 6 years) underwent acute PD. In-hospital mortality was 10.3%, increasing to 27.6% by 18 months.
- Of 14 children with available follow-up data, 57.1% progressed to CKD, while 42.9% experienced full renal recovery.
- Survival at 18 months was 66.0%, with children younger than 5 years showing a significantly higher likelihood of survival (OR, 3.217).
Conclusions:
- More than half of pediatric survivors of acute PD in resource-limited settings progress to CKD.
- Younger age (under 5 years) is a positive prognostic factor for survival following acute PD in this population.
- Further research and improved management strategies are needed for pediatric AKI in resource-limited settings.
Background:
There is a paucity of data on long term-outcomes of children who undergo acute peritoneal dialysis (PD) in resource-limited settings. We reviewed the outcomes of children who underwent PD after 18 months of follow-up.
Methods:
We conducted a prospective cohort study in children with acute kidney injury (AKI) who underwent PD. Diagnosis of AKI was based on the 2012 Kidney Disease: Improving Global Outcomes definition. We assessed outcomes of in-hospital mortality, 18-month post-dialysis survival, factors associated with survival, and progression to chronic kidney disease (CKD).
Results:
Twenty-nine children with a median age of 6 (3 to 11) years underwent acute PD. In-hospital mortality was 3/29 (10.3%) and rose to 27.6% during follow-up. Seven (24.1%) children were lost to follow-up. Of the 14 remaining children, six (42.9%) experienced full recovery of renal function, while eight (57.1%) progressed to CKD. Among those who experienced full recovery, median (interquartile range) estimated glomerular filtration rate (eGFR) rose from 12.67 (7.05, 22.85) mL/min/1.73 m2 to 95.56 (64.50, 198.00) mL/min/1.73 m2, P = 0.031. No significant changes in median eGFR from baseline were observed among those who progressed to CKD (P = 0.383) or in non-survivors (P = 0.838). According to Kaplan-Meier curve analyses, 18-month survival during follow-up was 66.0% (95% CI, 45.0% to 86.5%). Age < 5 was associated with greater likelihood of survival (OR, 3.217; 95% CI, 1.240 to 8.342).
Conclusion:
Progression of post-PD AKI to CKD occurred in more than half of survivors. Age < 5 was associated with greater likelihood of survival.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:30Peritoneal Dialysis I: Introduction and Procedure
01:25Peritoneal Dialysis III: Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care
01:28Kidney Transplant I: Introduction
01:29Acute Kidney Injury III: Clinical Manifestations