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Paediatric Dialysis at a Tertiary Hospital in South-West Nigeria: A 4-Year Report

Adebowale D Ademola1,2, Adanze O Asinobi1,2, Michael A Alao2

  • 1Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Blood Purification
|April 28, 2022
PubMed

Insights

Peritoneal dialysis (PD) and hemodialysis (HD) are vital for pediatric kidney disease in low-income countries. PD showed good outcomes for acute kidney injury (AKI), but more support is needed for pediatric dialysis programs.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Public Health in LMICs

Background:

  • Dialysis is crucial for children with acute kidney injury (AKI) or chronic kidney disease (CKD).
  • Access to dialysis is limited in low- and middle-income countries (LMICs).

Purpose of the Study:

  • To evaluate the outcomes of peritoneal dialysis (PD) and hemodialysis (HD) in Nigerian children with AKI and CKD.
  • To identify predictors of in-hospital mortality in pediatric patients with sepsis or malaria-induced AKI undergoing dialysis.

Main Methods:

  • A 4-year retrospective study of 167 children (aged 7 days to 18 years) treated with PD or HD.
  • Subgroup analysis focused on patients with sepsis or malaria AKI, examining dialysis modality and mortality predictors.

Main Results:

  • 129 children had AKI, and 38 had CKD. Overall mortality in AKI was 16.3%.
  • Sepsis AKI had higher mortality (RR 7.96) than malaria AKI. Mortality was 10.8% for HD-only and 26.2% for PD-only AKI.
  • Age, diagnosis, and dialysis modality were not independent risk factors for mortality.

Conclusions:

  • Peritoneal dialysis (PD) demonstrated relatively good outcomes for acute kidney injury (AKI) in a LMIC setting.
  • There is a need for increased funding and support to establish formal dialysis programs for pediatric AKI and CKD management in LMICs.
Abstract

Keywords:
Global healthHaemodialysisLow-income countries and lower-middle-income countriesPaediatric nephrologyPeritoneal dialysisSub-Saharan Africa

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