Support For Children with Chronic Renal Failure on Peritoneal Dialysis in an Adult Department: Experience of A Single Center
Abstract
Introduction: Renal failure is a serious condition that may occur in very young children. It is a common problem in nephrology; however, early diagnosis is important, and prognosis depends on the underlying etiology and early supportive care. Currently, it is possible in Algeria to provide care for these children in our adult nephrology department, thanks to recent progress in the treatment of this condition, represented by currently available dialysis methods adapted for children.
Patients and Methods: This is a retrospective study conducted from January 2008 to March 2018 at Beni Messous University Hospital, Algiers. We reviewed the records of 50 children treated in our peritoneal dialysis unit. The following parameters were studied: age, sex, initial nephropathy, dialysis modality and duration, and patient outcomes.
Results: Fifty children were included, comprising 19 boys and 31 girls, with ages ranging from 14 days to 16 years. The distribution of initial nephropathy was as follows: malformative uropathy in 13 children (26%), hereditary nephropathy in 9 children (18%), primary nephropathy in 8 children (16%), vascular nephropathy in 7 children (14%), secondary nephropathy in 3 children (6%), and indeterminate in 10 children (20%). The mean duration on dialysis was 13 months (range: 20 days to 4 years). The dialysis modality was automated peritoneal dialysis (APD) in 20 children (40%) and continuous ambulatory peritoneal dialysis (CAPD) in 30 children (60%). The outcomes of our patients were as follows: recovery of renal function in 10 children (20%), kidney transplantation in 3 children (6%), transfer to hemodialysis in 5 children (10%), death in 16 children (32%), and 16 children (32%) currently on peritoneal dialysis.
Discussion and Conclusion: The management of children on dialysis in an adult department is a major challenge; however, the technical platform (hardware, nursing, etc.) was adapted to their care. This experience demonstrates that peritoneal dialysis can be successfully performed in children within an adult nephrology department when appropriate resources and trained personnel are available. The mortality rate in our cohort (32%) is higher than that reported in developed countries but consistent with data from developing countries where resources are limited.
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References
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