| Autor: |
Nkoy AB; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Ndiyo YM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Matoka TT; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Odio BM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Kazadi OK; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Aloni MN; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Collard L; Division of Nephrology, Department of Pediatrics, Clinique de l'Espérance, CHC, Liège, Belgium., McCulloch M; Division of Paediatric Nephrology, Department of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, 37716University of Cape Town, South Africa., Ngiyulu RM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Gini JE; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., Lepira FB; Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo., van den Heuvel LP; Department of Pediatric Nephrology, 26657KU Leuven, Belgium.; Department of Development and Regeneration, 26657KU Leuven, Belgium., Levtchenko E; Department of Pediatric Nephrology, 26657KU Leuven, Belgium.; Department of Development and Regeneration, 26657KU Leuven, Belgium., Ekulu PM; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, 58820University of Kinshasa, Democratic Republic of Congo.; Department of Pediatric Nephrology, 26657KU Leuven, Belgium.; Department of Development and Regeneration, 26657KU Leuven, Belgium. |
| Abstrakt: |
In the Democratic Republic of Congo (DRC), acute kidney injury (AKI) contributes to the high rate of child mortality owing to the conjunction of poverty, deficiency of qualified health-care providers in pediatric nephrology, and the lack of pediatric dialysis programs. We aimed to describe the recent experience of the first pediatric acute peritoneal dialysis (PD) program in DRC. This is a retrospective cohort study on epidemiology, clinical features and outcomes of children admitted from January 2018 to January 2019 at the University Hospital of Kinshasa for AKI and treated with PD. This pediatric PD program started by a team of one physician and one nurse who were trained in the local production of PD fluids and bedside catheter insertion technique in Benin Republic. The training was jointly supported by the Flemish Inter-University Council (VLIR) TEAM project and Saving Young Lives (SYL) program of ISN, ISPD, EuroPD, and IPNA. From January 2018 to January 2019, 49 children (aged 4 months-15 years) were admitted for AKI mainly due to severe malaria and sepsis. Dialysis was indicated in 35 of 49 (71.4%), 32 of 35 (91.4%) were treated with PD, two with hemodialysis (HD) in adult ward and one died at admission. Data of the two patients transferred for HD were not available for follow-up. The main indications were uremia and prolonged anuria. Of 32 dialyzed patients, 24 (75%) recovered normal renal function 3 months after discharge. Peritonitis was observed in 2 of 32 (6.2%) patients and the mortality was 18.7%. This promising experience proves that with simple means including use of locally produced dialysis fluids and low peritonitis rates, we can effectively save lives of children suffering from AKI. |
