Acute Peritoneal Dialysis in African Pediatric Area Experience of Pediatric Nephrology Unit of Yopougon University Hospital (Abidjan, Côte d'Ivoire)

Abstract

Introduction: Acute kidney injury (AKI) is a diagnostic emergency threatening patients in a major way. Pediatric renal extra purification methods are limited in African countries due to the nonavailability of resources. Peritoneal dialysis (PD) seems to be the modality that is the most practiced for children with acute renal failure (ARF). Methodology: We conducted a retrospective study on 5 years of records of children from 1 month to 15 years who have suffered an ARF and benefited from PD while being treated at the pediatric nephrology unit of the Chu of Yopougon. ARF is defined as the condition that exists when the serum creatinine level is high or equal to 200 µmol/l outside any underlying uropathies. Results: Out of the hospitalized 88 children for AKI, 33 were on PD. Twenty-two children have been on dialysis while 9 children had to discontinue treatment due to financial problems. The sex ratio was 0.46 and the average age was 8.1. The etiologies of the AKI were predominantly glomerular diseases (45%), malaria (31.8%), and secondary interstitial nephritis of toxic origin. The indications of the PD are anuria (31%), hyperkalemia (18%), acute edema of lung (13%), and hyperuremia (13%). Eight children had automated peritoneal dialysis, 02 children underwent manual PD, and 9 children had both methods of treatment. We recorded 31 mechanical complications and 10 infections. While 8 children died, 10 recovered from AKI. Conclusion: Trained surgical medical personnel and favorable economic statuses of patients are the factors that will determine the success of PD in our country.

Challenges in the Recognition and Management of Acute Kidney Injury by Hospitals in Resource-Limited Settings

“…[22][23][24] Peritoneal dialysis, which is less complicated, requires less equipment and infrastructure, and is usually less expensive than hemodialysis, has proved to be effective in the treatment of AKI patients in African countries such as Tanzania, 25 Sudan, 26 Nigeria, 27,28 and Ivory Coast. 29 One must recognize that in some countries where PD fluids are not locally produced, it is difficult to import PD fluid and equipment, which can make PD more expensive and potentially unaffordable to most patients in need of renal replacement therapy.…”

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“…International studies, some of which are more extensive (higher number of patients) do not widen the gap with our results. Compared to African studies [23][24][25], our working conditions are much better in logistics for similar results. PD is a simple technique to master in an undemanding infrastructure that is an effective means of treatment everywhere even in the poorest areas.…”

Peritoneal Dialysis in Emergency in Children: Mono Centric Study in a Service of Adult Nephrology of Eastern Algeria

“…Depending on the facilities and skills available, PD, intermittent hemodialysis and haemodiafiltration are currently used for pediatric dialysis emergencies [19][20][21]. Hemodiafiltration and hemodialysis require vascular access, equipment, technical skills and financial resources [21][22][23], which limits their use due to unavailability in most centers in developing countries , including ours of a material suitable for different pediatric age groups, especially African studies [24][25][26], our working conditions are much better in logistics for similar results. PD is a simple technique to master in an undemanding infrastructure that is an effective means of treatment everywhere even in the poorest areas.…”