Peritoneal Dialysis in Children with Acute Kidney Injury: A Developing Country Experience

Abstract

Background

Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients.

Methods

The outcome of acute PD was studied in 57 children (39 boys) with AKI, aged 1 month to 12 years, at a tertiary care center of a teaching hospital in India.

Results

Hemolytic uremic syndrome (36.8%) was the most common cause of AKI, followed by septicemia (24.6%) and acute tubular necrosis (19.3%). Treatment with PD was highly effective in lowering retention markers (p < 0.001). Overall mortality was 36.8%. The risk of mortality by multivariate analysis was higher when patients were anuric [odds ratio (OR): 8.2; 95% confidence interval (CI): 1.3 to 49; p < 0.05], had septicemia (OR: 3.79; 95% CI: 1.55 to 25.8; p < 0.05), or severe infectious complications (OR: 8.2; 95% CI: 1.5 to 42.9; p < 001).

Conclusions

Because of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with AKI in resource-poor settings. Septicemia and severity of AKI are contributory factors to high mortality in pediatric acute kidney injury.