Palmer Dennis, Lawton William J, Barrier Charles, Fine B D, Hemphill Hayden, Nyah Norah Ndi, Kinne Virginie, Ringnwi Njaprim Ivor, Yong Genevive, Neufeldt Amy L, Mitterand Yves, Finkelstein Fredric O, Krahn Thomas A
Mbingo Baptist Hospital, Mbingo, Cameroon.
Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
Perit Dial Int. 2018 Jul-Aug;38(4):246-250. doi: 10.3747/pdi.2017.00190. Epub 2018 May 23.
Acute kidney injury (AKI) is common in low- and middle-income countries, and is associated with a high mortality. The high mortality rate is in large part due to the inability to perform dialysis in resource-limited settings. Due to significant cost advantages, peritoneal dialysis (PD) has been used to treat AKI in these settings. The costs, however, remain high when commercial solutions are used.
This is a retrospective cohort study of the outcome, and of the peritonitis rates, of patients with AKI treated with either commercially manufactured PD solutions or locally-made PD solutions. A program to treat AKI with PD was started at Mbingo Baptist Hospital in Cameroon. Between May 2013 and January 2015, solutions and connection sets were provided by the Saving Young Lives Program. From January 2015 through March 2017, solutions were locally produced and available tubing was used.
Mortality in hospitalized AKI patients was 28% during the period when commercial solutions and tubing were utilized, and 33% when locally produced solutions and available tubing were utilized. In both groups, peritonitis occurred in 16% of treatment courses.
Locally produced PD solutions, used with locally available tubing, were used to treat AKI with PD. The mortality and peritonitis rates were similar whether locally produced or commercial supplies were used.
急性肾损伤（AKI）在低收入和中等收入国家很常见，且与高死亡率相关。高死亡率很大程度上是由于在资源有限的环境中无法进行透析。由于成本优势显著，腹膜透析（PD）已被用于在这些环境中治疗AKI。然而，使用商业溶液时成本仍然很高。
这是一项回顾性队列研究，研究对象为用商业生产的PD溶液或自制PD溶液治疗的AKI患者的结局和腹膜炎发生率。喀麦隆的姆宾戈浸信会医院启动了一项用PD治疗AKI的项目。2013年5月至2015年1月期间，溶液和连接装置由拯救年轻生命项目提供。从2015年1月到2017年3月，溶液由当地生产，并使用了可用的管道。
在使用商业溶液和管道期间，住院AKI患者的死亡率为28%，在使用当地生产的溶液和可用管道时为33%。在两组中，16%的治疗疗程发生了腹膜炎。
使用当地生产的PD溶液和当地可用的管道，通过PD治疗AKI。无论使用当地生产的还是商业供应的产品，死亡率和腹膜炎发生率相似。
