尼日利亚西南部一家三级医院的儿科透析：4 年报告。
Paediatric Dialysis at a Tertiary Hospital in South-West Nigeria: A 4-Year Report.
机构信息
Department of Paediatrics, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Paediatrics, University College Hospital, Ibadan, Ibadan, Nigeria.
出版信息
Blood Purif. 2022;51(12):1015-1021. doi: 10.1159/000523746. Epub 2022 Apr 28.
INTRODUCTION
Dialysis is potentially lifesaving in children with acute kidney injury (AKI) or chronic kidney disease (CKD), but availability is limited in low-income countries and lower-middle-income countries (LMICs).
METHODS
In the present study, we perform a 4-year study of patients who received peritoneal dialysis (PD) or haemodialysis (HD) at the Paediatric Nephrology Unit of the University College Hospital Ibadan, Nigeria. Subgroup analysis was performed on patients with sepsis or malaria AKI who underwent HD or PD for predictors of in-hospital mortality.
RESULTS
A total of 167 children aged 7 days to 18 years, median 7 (interquartile range 3-12) years, (60.5% males) were studied. In total, 129 (77.2%) had AKI, while 38 had CKD. Regarding AKI, 83 children (64.3%) received HD only, 42 underwent PD only, while 4 underwent both HD and PD. Malaria AKI was treated with HD in 43 (51.8%) or PD in 8 (10.5%), while sepsis AKI was treated with HD in 20 (21.4%) or PD in 33 (78.6%). Mortality in AKI was 16.3% overall, 10.8% in children on HD only, and 26.2% in children on PD only. Patients with sepsis AKI had higher mortality compared to patients with malaria AKI (RR 7.96 [1.70-37.37]). Subgroup analysis showed that age, diagnosis, and dialysis modality were not independent risk factors for mortality. The aetiology of CKD was glomerulonephritis in 26 (68.4%): treatment was HD in 36 and PD in 2 with mortality being 26.3%.
CONCLUSIONS
PD for AKI showed relatively good outcomes in a LMIC. However, funding and support for a formal dialysis program for the management of AKI and CKD are needed.
简介
在患有急性肾损伤（AKI）或慢性肾脏病（CKD）的儿童中，透析具有潜在的救生作用，但在低收入国家和中低收入国家（LMICs）的可用性有限。
方法
在本研究中，我们对在尼日利亚伊巴丹大学学院医院儿科肾病科接受腹膜透析（PD）或血液透析（HD）的患者进行了为期 4 年的研究。对接受 HD 或 PD 治疗的败血症或疟疾 AKI 患者进行亚组分析，以确定院内死亡率的预测因素。
结果
共有 167 名年龄在 7 天至 18 岁之间的儿童（中位年龄 7 岁[四分位距 3-12 岁]），其中 60.5%为男性。共有 129 名（77.2%）患有 AKI，而 38 名患有 CKD。在 AKI 中，83 名儿童（64.3%）仅接受 HD 治疗，42 名仅接受 PD 治疗，而 4 名同时接受 HD 和 PD 治疗。43 名（51.8%）疟疾 AKI 患儿接受 HD 治疗，8 名（10.5%）接受 PD 治疗，20 名（21.4%）败血症 AKI 患儿接受 HD 治疗，33 名（78.6%）接受 PD 治疗。AKI 的总体死亡率为 16.3%，仅接受 HD 治疗的儿童死亡率为 10.8%，仅接受 PD 治疗的儿童死亡率为 26.2%。与疟疾 AKI 患者相比，败血症 AKI 患者的死亡率更高（RR 7.96[1.70-37.37]）。亚组分析显示，年龄、诊断和透析方式不是死亡率的独立危险因素。CKD 的病因是肾小球肾炎 26 例（68.4%）：HD 治疗 36 例，PD 治疗 2 例，死亡率为 26.3%。
结论
PD 治疗 AKI 在 LMIC 中显示出相对较好的结果。然而，需要为 AKI 和 CKD 的管理提供正式的透析计划的资金和支持。
Zotero 插件