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

Abstract

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.

Peritoneal Dialysis: A Life-Saving Measure in an Infant with a Single Functioning Kidney

“…As observed in our case, peritoneal dialysis has proven to be an effective method to restore electrolyte imbalances and promote recovery especially when the primary uro-surgical expertise and resources are limited. The technical simplicity of a peritoneal dialysis, the lack of a need for anticoagulation or placement of a central venous catheter, its excellent tolerance in hemodynamically unstable patients, and the provision of adequate clearances for most infants have made it an excellent and cheaper alternative when compared to hemodialysis for the management of acute kidney injury in children [1,2]. The technique to perform peritoneal dialysis in pediatric age group is not a mandatory skill that is required for a general paediatrician.…”

“…Peritoneal dialysis (PD) is an invasive procedural technique aims at recovering renal function in whom supportive therapy is not adequate to satisfy the metabolic demands [1]. Nowadays, with the advance of medical technology, the technique is only practiced in only few centers' as a result of lack of expertise, manpower, as well as equipment [2]. PD technique in pediatrics, particularly is not routinely trained as a core procedure among general pediatricians and not every general pediatrician has the skill and confidence to perform, especially in acute emergencies.…”

Preventing Acute Kidney Injury

“…[52][53][54][55] In centers with experience in the technique, PD is a safe and less expensive RRT method, particularly useful in areas with less developed health infrastructure. [56][57][58] Intraperitoneal flexible catheters should be preferentially used for acute PD. 59 Trained nephrologists, intensivists, or emergency care physicians can perform the insertion procedure.…”

Клінічні Та Організаційні Проблеми Застосування Перитонеального Діалізу

“…Щодо оцінки якості життя пацієнтів із термінальною стадією ХХН, зацікавленість викликає дослідження, за результатами якого якість життя пацієнтів при застосуванні ПД значно вища, ніж при проведенні амбулаторного ГД [5].…”

“…Щодо цього, на увагу заслуговують дані досліджень, проведених в Нігерії. Їхні результати не тільки показали велику перевагу ПД у фінансовому плані перед ГД, але також дозволили судити про ефективність ПД у лікуванні гострого ушкодження нирок (ГУН) у пацієнтів дитячого віку [5].…”