Keita Younoussa, Keita Niakhaleen, Preka Evgenia, Jatt Tshabayembi, Ndongo Aliou Abdoulaye, Niang Abdou, Boyer Annabel, Daireaux Clémence Bechade, Lobbedez Thierry, Picca Stefano, Boyer Olivia
Department of Paediatrics, Abass Ndao Hospital Dakar Senegal, Dakar, Senegal.
Nephrology Department, Dalal Diam Hospital, Dakar, Senegal.
Pediatr Nephrol. 2025 Sep 3. doi: 10.1007/s00467-025-06933-9.
The percutaneous insertion of a peritoneal dialysis (PD) catheter by a nephrologist offers a plausible alternative to surgical insertion, improving access to dialysis. We report the experience of the paediatric nephrology unit in Dakar, Senegal, initiating PD for children with acute kidney injury (AKI), using a haemodialysis catheter inserted via a modified Seldinger technique. This approach was chosen due to its availability and cost-free provision, addressing resource constraints effectively.
This pilot case series study describes a cohort of nine children with AKI managed using this innovative technique between March and October 2024 in Dakar, Senegal.
Nine children, including two neonates with life-threatening AKI, were included. Mean age was 4.5 years, with a male-to-female ratio of 1.25. Infections accounted for 44.4% (n = 4) of the cases. Catheter insertion in the peritoneal cavity was successful in eight out of nine cases; one mispositioned catheter (case 9) was removed and excluded from analysis. During the first week, no cases of bleeding or dialysate leakage occurred at the insertion site. Peritonitis was observed in two cases after > 2 weeks. Of the eight children with successful catheter placement, five stabilised on PD (62.5%); and of those five, two (40%) fully recovered kidney function. Three children (37.5%) succumbed to septic shock from the underlying infection.
Within the "Saving Young Lives" programme, our small case series showed that a haemodialysis catheter can feasibly deliver paediatric emergency PD in Dakar. Safety, efficacy, and programme-level impact must be confirmed in larger, multi-centre studies before wider training and implementation.
由肾病学家经皮插入腹膜透析（PD）导管为手术插入提供了一种可行的替代方法，改善了透析通路。我们报告了塞内加尔达喀尔儿科肾病科使用经改良Seldinger技术插入的血液透析导管为急性肾损伤（AKI）儿童启动PD的经验。选择这种方法是因为其可用性和免费提供，有效解决了资源限制问题。
本前瞻性病例系列研究描述了2024年3月至10月在塞内加尔达喀尔使用这种创新技术管理的9例AKI儿童队列。
纳入9例儿童，包括2例患有危及生命的AKI的新生儿。平均年龄为4.5岁，男女比例为1.25。感染占病例的44.4%（n = 4）。9例中有8例成功将导管插入腹腔；1例导管位置不当（病例9）被移除并排除在分析之外。在第一周，插入部位未发生出血或透析液渗漏病例。>2周后观察到2例腹膜炎。在导管放置成功的8例儿童中，5例在PD治疗下病情稳定（62.5%）；在这5例中，2例（40%）肾功能完全恢复。3例儿童（37.5%）因基础感染死于感染性休克。
在“拯救年轻生命”计划中，我们的小病例系列表明，血液透析导管在达喀尔可为儿科紧急PD提供可行的治疗。在进行更广泛的培训和实施之前，必须在更大规模的多中心研究中确认安全性、有效性和项目层面的影响。
