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非洲儿科地区急性腹膜透析——约普贡大学医院(阿比让,科特迪瓦)儿科肾脏病科的经验

Acute peritoneal dialysis in African pediatric area experience of pediatric nephrology unit of Yopougon University Hospital (Abidjan, Côte d'Ivoire).

作者信息

Diarrassouba Gnenefoly, Adonis-Koffy Laurence, Niamien Ekou, Yaokreh Jean Baptiste, Coulibaly Pessa Albert

机构信息

Pediatric Nephrology unit CHU of Yopougon, Abidjan, Côte d'Ivoire.

出版信息

Blood Purif. 2015;39(1-3):141-4. doi: 10.1159/000368938. Epub 2015 Jan 20.

Abstract

INTRODUCTION

Acute kidney injury (AKI) is a diagnostic emergency threatening patients in a major way. Pediatric renal extra purification methods are limited in African countries due to the nonavailability of resources. Peritoneal dialysis (PD) seems to be the modality that is the most practiced for children with acute renal failure (ARF).

METHODOLOGY

We conducted a retrospective study on 5 years of records of children from 1 month to 15 years who have suffered an ARF and benefited from PD while being treated at the pediatric nephrology unit of the Chu of Yopougon. ARF is defined as the condition that exists when the serum creatinine level is high or equal to 200 µmol/l outside any underlying uropathies.

RESULTS

Out of the hospitalized 88 children for AKI, 33 were on PD. Twenty-two children have been on dialysis while 9 children had to discontinue treatment due to financial problems. The sex ratio was 0.46 and the average age was 8.1. The etiologies of the AKI were predominantly glomerular diseases (45%), malaria (31.8%), and secondary interstitial nephritis of toxic origin. The indications of the PD are anuria (31%), hyperkalemia (18%), acute edema of lung (13%), and hyperuremia (13%). Eight children had automated peritoneal dialysis, 02 children underwent manual PD, and 9 children had both methods of treatment. We recorded 31 mechanical complications and 10 infections. While 8 children died, 10 recovered from AKI.

CONCLUSION

Trained surgical medical personnel and favorable economic statuses of patients are the factors that will determine the success of PD in our country.

摘要

引言

急性肾损伤(AKI)是一种严重威胁患者的诊断急症。由于资源匮乏,非洲国家的儿科肾脏替代治疗方法有限。腹膜透析(PD)似乎是急性肾衰竭(ARF)患儿最常用的治疗方式。

方法

我们对在约普贡大学医院儿科肾病科接受治疗并因ARF接受PD治疗的1个月至15岁儿童的5年记录进行了回顾性研究。ARF定义为在无任何潜在泌尿系统疾病的情况下,血清肌酐水平高于或等于200µmol/l时存在的状况。

结果

在因AKI住院的88名儿童中,33名接受了PD治疗。22名儿童接受了透析治疗,9名儿童因经济问题不得不停止治疗。性别比为0.46,平均年龄为8.1岁。AKI的病因主要为肾小球疾病(45%)、疟疾(31.8%)和中毒性继发性间质性肾炎。PD的适应证为无尿(31%)、高钾血症(18%)、急性肺水肿(13%)和高尿素血症(13%)。8名儿童接受了自动化腹膜透析,2名儿童接受了手动PD,9名儿童两种治疗方法都采用过。我们记录到31例机械并发症和10例感染。8名儿童死亡,10名儿童从AKI中康复。

结论

训练有素的外科医务人员和患者良好的经济状况是决定我国PD治疗成功与否的因素。

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