Abdelraheem Mohamed, Ali El-Tigani, Osman Rania, Ellidir Rashid, Bushara Amna, Hussein Rasha, Elgailany Shiraz, Bakhit Yassir, Karrar Mohamed, Watson Alan, Abu-Aisha Hasan
Pediatric Nephrology Unit Soba University Hospital, University of Khartoum, Sudan; Children's Renal & Urology Unit, Nottingham University Hospitals, Nottingham, UK; and Sudan PD program, Khartoum, Sudan.
Perit Dial Int. 2014 Jul-Aug;34(5):526-33. doi: 10.3747/pdi.2013.00082. Epub 2014 Mar 1.
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Acute Kidney Injury (AKI) is an important cause of morbidity and mortality in developing countries. Although continuous renal replacement therapy is gaining more popularity worldwide, peritoneal dialysis (PD) in children remains an appropriate therapy for AKI in children for all age groups including neonates. ♦
We retrospectively reviewed all children who have been admitted with AKI at the pediatric nephrology unit, Soba University Hospital, Khartoum, during the period from January 2005 to December 2011. ♦
Over 7 years we recorded 659 children of whom 362 (54.9%) were male. The spectrum of age was variable with the majority being neonates, 178 (27.1%). The average patient admission rate was 94 patients per year, with an estimated incidence of 9.8 patients/million population/year. Common causes of AKI were sepsis 202 (30.8%), acute glomerulonephritis 75 (11.5%) and obstructive uropathy due to stones 56 (8.5%). The most common dialysis modality used was PD, 343 (52.4%), and peritonitis was reported in 53 (15.4%) patients. Recovery from AKI was achieved in 450 (68.9%) children, 37 (5.7%) went into chronic kidney disease (CKD), 33 (5.1%) referred to the pediatric surgery and 194 (29.7%) died. ♦
In the setting of developing countries where AKI is a common cause of morbidity and mortality, reasonably equipped renal units with adequately trained medical staff may save many lives. International funding programs for communicable diseases and charity organizations should include AKI management in their programs. Acute PD remains the treatment modality of choice for AKI in developing countries.
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急性肾损伤(AKI)是发展中国家发病和死亡的重要原因。尽管连续性肾脏替代治疗在全球越来越普及,但对于包括新生儿在内的所有年龄组儿童,腹膜透析(PD)仍是治疗儿童AKI的一种合适疗法。♦
我们回顾性分析了2005年1月至2011年12月期间在喀土穆索巴大学医院儿科肾病科因AKI入院的所有儿童。♦
在7年期间,我们记录了659名儿童,其中362名(54.9%)为男性。年龄范围各异,大多数是新生儿,有178名(27.1%)。患者平均入院率为每年94例,估计发病率为9.8例/百万人口/年。AKI的常见病因是败血症202例(30.8%)、急性肾小球肾炎75例(11.5%)和结石所致梗阻性尿路病56例(8.5%)。最常用的透析方式是PD,有343例(52.4%),53例(15.4%)患者报告发生了腹膜炎。450名(68.9%)儿童的AKI得以恢复,37名(5.7%)发展为慢性肾脏病(CKD),33名(5.1%)转诊至小儿外科,194名(29.7%)死亡。♦
在AKI是发病和死亡常见原因的发展中国家,配备合理且有充分培训的医务人员的肾脏科室可能挽救许多生命。传染病国际资助项目和慈善组织应将AKI管理纳入其项目中。急性PD仍然是发展中国家治疗AKI的首选治疗方式。