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Paediatric dialysis at a tertiary hospital in South-West Nigeria: A 4-year report

Introduction: Dialysis is potentially lifesaving in children with acute kidney injury (AKI) or chronic kidney disease (CKD), but availability is limited in low-income countries and lower-middle-income countries (LMICs). Methods: In the present study, we perform a 4-year study of patients who receiv...

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Published: 2022
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LEADER 00000njm a2000000a 4500
001 oai:repository.ui.edu.ng:123456789/12252
042 |a dc 
720 |a Ademola, A. D.  |e author 
720 |a Asinobi, A. O.  |e author 
720 |a Alao, M. A.  |e author 
720 |a Wade, A. W.  |e author 
260 |c 2022 
520 |a Introduction: Dialysis is potentially lifesaving in children with acute kidney injury (AKI) or chronic kidney disease (CKD), but availability is limited in low-income countries and lower-middle-income countries (LMICs). Methods: In the present study, we perform a 4-year study of patients who received peritoneal dialysis (PD) or haemodialysis (HD) at the Paediatric Nephrology Unit of the University College Hospital Ibadan, Nigeria. Subgroup analysis was performed on patients with sepsis or malaria AKI who underwent HD or PD for predictors of in-hospital mortality. Results: A total of 167 children aged 7 days to 18 years, median 7 (interquartile range 3–12) years, (60.5% males) were studied. In total, 129 (77.2%) had AKI, while 38 had CKD. Regarding AKI, 83 children (64.3%) received HD only, 42 underwent PD only, while 4 underwent both HD and PD. Malaria AKI was treated with HD in 43 (51.8%) or PD in 8 (10.5%), while sepsis AKI was treated with HD in 20 (21.4%) or PD in 33 (78.6%). Mortality in AKI was 16.3% overall, 10.8% in children on HD only, and 26.2% in children on PD only. Patients with sepsis AKI had higher mortality compared to patients with malaria AKI (RR 7.96) [1.70–37.37]). Subgroup analysis showed that age, diagnosis, and dialysis modality were not independent risk factors for mortality. The aetiology of CKD was glomerulonephritis in 26 (68.4%): treatment was HD in 36 and PD in 2 with mortality being 26.3%. Conclusions: PD for AKI showed relatively good outcomes in a LMIC. However, funding and support for a formal dialysis program for the management of AKI and CKD are needed. 
024 8 |a 1421-9735 
024 8 |a ui_art_ademola_paediatric_2022 
024 8 |a DOI: 10.1159/000523746 
024 8 |a https://repository.ui.edu.ng/handle/123456789/12252 
653 |a Peritoneal dialysis 
653 |a Haemodialysis 
653 |a Paediatric nephrology 
653 |a Sub-Saharan Africa 
653 |a Low-income countries and lowermiddle-income countries 
653 |a Global health 
245 0 0 |a Paediatric dialysis at a tertiary hospital in South-West Nigeria: A 4-year report