A Retrospective Study On The Outcomes Of Peritoneal Dialysis Among Pediatric Patients With Acute Kidney Injury At The Kenyatta National Hospital.

Abstract

Background: Epidemiological evidence supports the view that even mild, reversible acute kidney injury (AKI), has important clinical consequences that may include increased risk of death. The management of AKI is directed towards restoring normal chemical balance with the dialytic interventions for infants and children taking different forms but peritoneal dialysis (PD) has been preferred because of its efficacy. Aim of the study: To establish the outcomes of PD on pediatric patients in Kenyatta National Hospital (KNH). Methodology: The study design was a retrospective cohort study. The study population was pediatric patients managed on PD due to AKI for the period, January 2017 to December 2017. The sample size was 102 files calculated using Yamene Taros formula. Convenience sampling method was used. Data was collected using a structured checklist, then entered, cleaned and analyzed using a computer software package, SPSS. Paired t-test was used to determine biochemistry parameter before commencement of PD and on discontinuation of PD. The statistical significance was set up at p<0.005. Results: The survival rate was 58.8% and mortality rate 41.2 %. None of the participants progressed to chronic renal disease. The mean Serum Creatinine was higher (602) prior to PD and lower on discontinuation (243). Serum urea level was higher prior to PD and lower on discontinuation of PD (51.49>14.58). Conclusion: A higher percentage of the participants had successful restoration of kidney functions however the mortality rate at 41.2% is still a high percentage. There is evidence that PD is an effective modality in reduction of elevated serum urea and creatinine in treatment of AKI in pediatric patients. Recommendations: There is need to carry out a random controlled study in pediatric patients on PD due to AKI to determine the outcomes after PD therapy.