scholarly journals Peritoneal dialysis for acute kidney injury in sub-Saharan Africa: challenges faced and lessons learned at Kilimanjaro Christian Medical Centre

2012 ◽  
Vol 81 (4) ◽  
pp. 331-333 ◽  
Author(s):  
John G. Callegari ◽  
Kajiru G. Kilonzo ◽  
Karen E. Yeates ◽  
Garry J. Handelman ◽  
Fredric O. Finkelstein ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Lessons Learned ◽  
Medical Centre ◽  
Sub Saharan Africa ◽  
Kilimanjaro Christian Medical Centre ◽  
Sub Saharan

scholarly journals Peritoneal Dialysis as a Mode of Treatment for Acute Kidney Injury in Sub-Saharan Africa

2013 ◽  
Vol 36 (3-4) ◽  
pp. 226-230 ◽  
Author(s):  
John Callegari ◽  
Sampson Antwi ◽  
Grzegorz Wystrychowski ◽  
Ewa Zukowska-Szczechowska ◽  
Nathan W. Levin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review

2016 ◽  
Vol 4 (4) ◽  
pp. e242-e250 ◽  
Author(s):  
Wasiu A Olowu ◽  
Abdou Niang ◽  
Charlotte Osafo ◽  
Gloria Ashuntantang ◽  
Fatiu A Arogundade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Peritoneal Dialysis in Childhood Acute Kidney Injury: Experience in Southwest Nigeria

2012 ◽  
Vol 32 (3) ◽  
pp. 267-272 ◽  
Author(s):  
Adebowale Dele Ademola ◽  
Adanze Onyenonachi Asinobi ◽  
Oluwatoyin Olufunmilayo Ogunkunle ◽  
Bamidele Nurudeen Yusuf ◽  
Olalekan Ezekiel Ojo
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Acute Glomerulonephritis ◽  
Complication Rates ◽  
Care Hospital ◽  
Low Resource Settings ◽  
Low Resource ◽  
Southwest Nigeria

BackgroundThe choices for renal replacement therapy (RRT) in childhood acute kidney injury (AKI) are limited in low-resource settings. Peritoneal dialysis (PD) appears to be the most practical modality for RRT in young children with AKI in such settings. Data from sub-Saharan Africa on the use of PD in childhood AKI are few.MethodsWe performed a retrospective study of children who underwent PD for AKI at a tertiary-care hospital in southwest Nigeria from February 2004 to March 2011 (85 months).ResultsThe study included 27 children (55.6% female). Mean age was 3.1 ± 2.6 years, with the youngest being 7 days, and the oldest, 9 years. The causes of AKI were intravascular hemolysis ( n = 11), septicemia ( n = 8), acute glomerulonephritis ( n = 3), gastroenteritis ( n = 3), and hemolytic uremic syndrome ( n = 2). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. Duration of PD ranged from 6 hours to 12 days (mean: 5.0 ± 3.3 days). The main complications were peritonitis ( n = 10), pericatheter leakage ( n = 9), and catheter outflow obstruction ( n = 5). Of the 27 patients, 19 (70%) survived till discharge.ConclusionsIn low-resource settings, PD can be successfully performed for the management of childhood AKI. In our hospital, the use of adapted catheters may have contributed to the high complication rates. Peritoneal dialysis should be promoted for the management of childhood AKI in low-resource settings, and access to percutaneous or Tenckhoff catheters, dialysis fluid, and automated PD should be increased.

scholarly journals Acute pediatric peritoneal dialysis: impact of an opt-out model and adaptable methods in a hospital in Nigeria

2020 ◽  
Vol 29 (4) ◽  
pp. 386-91
Author(s):  
Michael Abel Alao ◽  
Olayinka Rasheed Ibrahim ◽  
Olajide Olusegun Abiola ◽  
Daniel Adedosu Gbadero ◽  
Adanze Onyenonachi Asinobi
Keyword(s):  
Peritoneal Dialysis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Access Rate ◽  
Opt Out ◽  
Catheter Malfunction ◽  
Scrotal Edema ◽  
Sub Saharan

BACKGROUND Despite efforts to scale peritoneal dialysis (PD) uptake, access is still limited in Sub-Saharan Africa, including Nigeria. Thus, this study evaluated access to PD, cost-effectiveness, complications, and in-hospital mortality rate following the adoption of a local opt-out model approach for all children with acute kidney injury (AKI) that required PD.  METHODS This work was a retrospective review of 33 children with AKI that required dialysis between December 2014 and November 2016. PD was carried out using locally adaptable consumables in place of commercially produced consumables. All patients that required renal replacement therapy (RRT) were offered an option to opt-out irrespective of their financial status. Patients’ relevant data were retrieved from the case notes and analyzed.  RESULTS The median age was 7 years (range 3–12). 23 patients (70%) were males. Of the 33 patients that required RRT, 29 had PD. The children had an access rate of 88% (95% CI = 76.77–99.03). The access rate was not related to gender (p = 1.000), age group (p = 0.240), or socioeconomic status (p = 0.755). Complications were pericatheter leakage of fluid (n = 7, 24%), catheter malfunction (n = 5, 17%), abdominal wall edema (n = 3, 10%), scrotal edema (n = 2, 7%), and peritonitis (n = 1, 3%). In-hospital mortality was 3/29 (10%; 95% CI = 2.2–27.3). Cost analysis revealed that the cost of consumables was reduced by 88.5%.  CONCLUSIONS An opt-out model with the use of locally adaptable consumables improved PD access (88%) with a low in-hospital mortality rate. 

scholarly journals Acute kidney injury among paediatric emergency room admissions in a tertiary hospital in South West Nigeria: a cohort study

2018 ◽  
Vol 12 (4) ◽  
pp. 521-526 ◽  
Author(s):  
Adebowale D Ademola ◽  
Adanze O Asinobi ◽  
Esther Ekpe-Adewuyi ◽  
Adejumoke I Ayede ◽  
Samuel O Ajayi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Emergency Room ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Care Hospital ◽  
College Hospital ◽  
Paediatric Emergency ◽  
Sub Saharan

Abstract Background Epidemiological data on paediatric acute kidney injury (AKI) in sub-Saharan Africa are limited and largely retrospective. We performed a prospective study of AKI among patients admitted through the emergency room. Methods Children admitted to the post-neonatal emergency room of the University College Hospital, Ibadan, Nigeria between February 2016 and January 2017 were studied. AKI was defined by Kidney Disease: Improving Global Outcomes serum creatinine criteria. AKI ascertainment relied on serum creatinine measurements carried out in routine care by post-admission Day 1. We compared in-hospital mortality by post-admission Day 7 for patients with and without AKI (no-AKI). Results Of the 1344 children admitted to the emergency room, 331 were included in the study. AKI occurred in 112 patients (33.8%) with a median age of 3.1 years [interquartile range (IQR) 0.9–9.4] and was Stage 3 in 50.5% of the cases. The no-AKI group had a median age of 1.8 (IQR 0.7–5.8) years. The underlying diagnoses in patients with AKI were sepsis (33.0%), malaria (12.5%) and primary renal disorders (13.4%). Twenty-four of the patients with AKI underwent dialysis: haemodialysis in 20 and peritoneal dialysis in 4. By Day 7 of admission, 7 of 98 (7.1%) patients in the AKI group had died compared with 5 of 175 (2.9%) patients in the no-AKI group [odds ratio 2.6 (95% confidence interval 0.8–8.5)]. Outcome data were not available for 58 (17.5%) patients. Conclusions AKI is common among paediatric emergency room admissions in a tertiary care hospital in sub-Saharan Africa. It is associated with high mortality risk that may be worse in settings without dialysis.

scholarly journals PAEDIATRIC ACUTE PERITONEAL DIALYSIS IN SOKOTO: REVIEW AND OUTCOME

2021 ◽  
Vol 2 (1) ◽  
pp. 507-512
Author(s):  
Ibitoye PK ◽  
Jiya FB
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Cost Effective ◽  
Diarrhoeal Disease ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Obstructive Nephropathy ◽  
Acute Glomerulonephritis ◽  
Bacterial Peritonitis ◽  
Sub Saharan

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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