Fredrick Francis, Valentine Gudila
Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania.
J Med Case Rep. 2013 Jun 28;7:168. doi: 10.1186/1752-1947-7-168.
Severe acute malnutrition is common in developing countries. Children with severe acute malnutrition are prone to complications, including electrolyte imbalance and infections. Our patient was an 18-month-old boy who had severe acute malnutrition (kwashiorkor) and developed acute kidney injury, which was managed with peritoneal dialysis using improvised equipment. This case report illustrates the importance of improvisation in resource-limited settings in providing lifesaving treatment. To the best of our knowledge, this is the first case report on peritoneal dialysis in a child with severe acute malnutrition (kwashiorkor).
We report a case of an 18-month-old Bantu-African Tanzanian boy who had severe malnutrition and developed anuric acute kidney injury. He had severe renal dysfunction and was managed with peritoneal dialysis using an improvised catheter and bedside constituted fluids (from intravenous fluids) and was diuretic after 7 days of peritoneal dialysis, with complete recovery of renal functions after 2 weeks.
Children with severe acute malnutrition who develop acute kidney injury should be offered peritoneal dialysis, which may be provided using improvised equipment in resource-limited settings, as illustrated in this case report.
重度急性营养不良在发展中国家很常见。患有重度急性营养不良的儿童容易出现并发症，包括电解质失衡和感染。我们的患者是一名18个月大的男孩，患有重度急性营养不良（夸希奥科病）并发展为急性肾损伤，通过使用简易设备进行腹膜透析进行治疗。本病例报告说明了在资源有限的环境中，临时拼凑设备在提供挽救生命的治疗方面的重要性。据我们所知，这是首例关于重度急性营养不良（夸希奥科病）儿童腹膜透析的病例报告。
我们报告了一例18个月大的班图族坦桑尼亚男孩，他患有重度营养不良并发展为无尿性急性肾损伤。他有严重的肾功能障碍，通过使用简易导管和床边配制的液体（来自静脉输液）进行腹膜透析治疗，腹膜透析7天后出现利尿，2周后肾功能完全恢复。
如本病例报告所示，患有重度急性营养不良并发展为急性肾损伤的儿童应接受腹膜透析治疗，在资源有限的环境中可使用简易设备进行腹膜透析。
