scholarly journals Peritoneal Dialysis in Children with Acute Kidney Injury: Dhaka Shishu (Children) Hospital Experience

2017 ◽  
Vol 6 (2) ◽  
pp. 11-14
Author(s):  
NK Sarker ◽  
M Hanif ◽  
MA Rouf ◽  
PK Sarkar ◽  
S Mahmud ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Developing Countries ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Unknown Etiology ◽  
Cross Sectional ◽  
Wasp Sting ◽  
Medical College ◽  
Common Causes ◽  
Uremic Syndrome

Background: The choices for renal replacement therapy (RRT) in children with acute kidney injury (AKI) are limited in developing countries. Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients.Methods: This is a cross sectional descriptic type of observational study of children who underwent PD for AKI in 43 children (27 boys) in nephrology department of Dhaka Shishu (children) Hospital from January 2013 to December 2013.Result: The study included 43 children (62.8 % male). Mean age was 2 ± 1.07 years, with the youngest being 2 months, and the oldest, 14 years. Most common causes was septicaemia (25.6%) and hypovolumia (25.6%) followed by unknown etiology (16.2%), glomerulonephritis (11.6%), wasp sting (9.3%) and hemolytic uremic syndrome (7%). Overall mortality was 32.5%, most common in unknown etiology and high in male but not statistically significant (p=0.42).Conclusions: In the developing countries, PD can be successfully performed for the management of childhood AKI. Septicaemia and hypovolumia are the leading causes of AKI, however mortality higher in male and unknown etiology.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 11-14

scholarly journals Acute Kidney Injury in Patients of Intensive Care Unit

2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Type I ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Failure Group ◽  
Medical College

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

scholarly journals Catheter Access Management for Acute Peritoneal Dialysis

2020 ◽  
Vol 10 (1) ◽  
pp. 35-41
Author(s):  
Mohamed Amine Rahil ◽  
Achour Bouzgueg
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Central Vein ◽  
Access Management ◽  
Chronic Complications ◽  
Vein Catheter ◽  
Uremic Syndrome ◽  
Central Vein Catheter ◽  
Almost All

Insertion of a peritoneal dialysis (PD) catheter is frequently done by interventional nephrologists, but these procedures are typically only performed for adults. Almost all invasive procedures in children are performed by pediatric surgeons. If a pediatric surgeon is unavailable, the initiation of PD in acute situations may be delayed, thus increasing the risk of complications and chronic kidney disease. For these patients, the main obstacle to initiating renal replacement therapy is access, even when involving central vein catheter (CVC) or peritoneal access. Here we report the case of a 10-kg baby affected by hemolytic and uremic syndrome diarrhea in whom all of the procedures to manage the complications of acute kidney injury (PD catheter insertion, PD catheter revision, CVC placement, and CVC revision) were undertaken by interventional nephrologists. This experience allowed us to rapidly treat the acute kidney injury, recover normal kidney function thereby avoiding chronic complications, and allowing us to discharge the baby from the intensive care unit.

scholarly journals Acute Kidney Injury in Children: Etiologies and Results

2020 ◽  
Vol 1 (2) ◽  
pp. 01-05
Author(s):  
Seba Atmane
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Hemolytic Uremic Syndrome ◽  
Kidney Function ◽  
Emergency Treatment ◽  
Kidney Injury ◽  
Obstructive Nephropathy ◽  
Normal Kidney ◽  
Uremic Syndrome

The aim of the study is to show the etiologies and the follow-up of our AKI cases. This was conducted in our hospital, between 2015 and 2018. During this period we included 26 children with AKI (64% femals) with a median age of 7 years (range 40 days to 15 years). In the majority of the cases revealed by digestive signs and that related to the etiology of AKI (Hemolytic Uremic Syndrome post diarrhea). In our study, 44% of the patients have thrombocytopenia associated with AKI. The etiology of AKI is : Nephropathy glomerular in 37% hemolytic and uremic syndrom in 54% and obstructive nephropathy in 9%. Patients survived in 92 % of the cases and 58% of them have recovered normal kidney function, 7% of death. Peritoneal dialysis is the most commonly used emergency treatment for AKI in children at a frequency of 37%., hemodialysis was used less.

scholarly journals Acute kidney injury is a common complication after acute stroke in Mymensingh Medical College Hospital

2016 ◽  
Vol 44 (2) ◽  
pp. 82-86
Author(s):  
Nitai Chandra Ray ◽  
Md Ayub Ali Chowdhury ◽  
Ashutosh Saha Roy ◽  
Md Abdul Muqueet ◽  
Binoy Paul ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Stroke ◽  
Kidney Injury ◽  
Developed Countries ◽  
Common Complication ◽  
Stroke Patients ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Burden

Stroke represents a continuously evolving medical and social problem, being the third leading cause of death after heart disease and cancer in developed countries. Acute kidney injury (AKI) may develop as a possible complication after acute stroke. Insufficient care of acute stroke patients is an important factor behind it. It may be associated with a significant burden of morbidity and mortality. This cross sectional observational study was conducted in Mymensingh Medical College & Hospital, Mymensingh from July 2012 to June 2014. A total of 240 patients with newly detected acute stroke confirmed by CT scan of brain were included in this study. According to this study, 15.42% of acute stroke patients developed AKI. Majority (54.05%) of the AKI patients were in >60 years age group. 17.93 % of male patients developed AKI and 11.58% of female patients developed AKI. So, AKI was a common complication after acute stroke. Early diagnosis and management of AKI may be an important part of management of these stroke patients.Bangladesh Med J. 2015 May; 44 (2): 82-86

scholarly journals Peritoneal Dialysis in Renal Replacement Therapy for Patients with Acute Kidney Injury

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Naheed Ansari
Keyword(s):  
Acute Kidney Injury ◽  
Developing Countries ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Hemodynamic Instability ◽  
Renal Replacement Therapies ◽  
Continuous Renal Replacement Therapies ◽  
Trained Staff

Peritoneal dialysis (PD) was the first modality used for renal replacement therapy (RRT) of patients with acute kidney injury (AKI) because of its inherent advantages as compared to Hemodialysis. It provides the nephrologist with nonvascular alternative for renal replacement therapy. It is an inexpensive modality in developing countries and does not require highly trained staff or a complex apparatus. Systemic anticoagulation is not needed, and it can be easily initiated. It can be used as continuous or intermittent procedure and, due to slow fluid and solute removal, helps maintain hemodynamic stability especially in patients admitted to the intensive care unit. PD has been successfully used in AKI involving patients with hemodynamic instability, those at risk of bleeding, and infants and children with AKI or circulatory failure. Newer continuous renal replacement therapies (CRRTs) are being increasingly used in renal replacement therapy of AKI with less use of PD. Results of studies comparing newer modalities of CRRT versus acute peritoneal dialysis have been conflicting. PD is the modality of choice in renal replacement therapy in pediatric patients and in patients with AKI in developing countries.

scholarly journals Peritoneal Dialysis in Children with Acute Kidney Injury: A Developing Country Experience

2012 ◽  
Vol 32 (4) ◽  
pp. 431-436 ◽  
Author(s):  
Om P. Mishra ◽  
Aditya K. Gupta ◽  
Vishal Pooniya ◽  
Rajniti Prasad ◽  
Narendra K. Tiwary ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Care Center ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Infectious Complications ◽  
Tubular Necrosis ◽  
Appropriate Treatment ◽  
Risk Of Mortality ◽  
Uremic Syndrome

BackgroundPeritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients.MethodsThe outcome of acute PD was studied in 57 children (39 boys) with AKI, aged 1 month to 12 years, at a tertiary care center of a teaching hospital in India.ResultsHemolytic uremic syndrome (36.8%) was the most common cause of AKI, followed by septicemia (24.6%) and acute tubular necrosis (19.3%). Treatment with PD was highly effective in lowering retention markers ( p < 0.001). Overall mortality was 36.8%. The risk of mortality by multivariate analysis was higher when patients were anuric [odds ratio (OR): 8.2; 95% confidence interval (CI): 1.3 to 49; p < 0.05], had septicemia (OR: 3.79; 95% CI: 1.55 to 25.8; p < 0.05), or severe infectious complications (OR: 8.2; 95% CI: 1.5 to 42.9; p < 001).ConclusionsBecause of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with AKI in resource-poor settings. Septicemia and severity of AKI are contributory factors to high mortality in pediatric acute kidney injury.

scholarly journals Peritoneal Dialysis for Children with Acute Kidney Injury in Lagos, Nigeria: Experience with Adaptations

2014 ◽  
Vol 34 (5) ◽  
pp. 534-538 ◽  
Author(s):  
Christopher Imokhuede Esezobor ◽  
Taiwo Augustina Ladapo ◽  
Foluso Ebun Lesi
Keyword(s):  
Acute Kidney Injury ◽  
Developing Countries ◽  
Peritoneal Dialysis ◽  
Medical Records ◽  
Public Hospital ◽  
Kidney Injury ◽  
Common Complication ◽  
Professional Groups ◽  
Good Outcome ◽  
The Impact

IntroductionInternational professional groups are supporting the training of physicians in developing countries in nephrology, including peritoneal dialysis (PD). This report documents the impact of such efforts in the provision of manual PD for children with acute kidney injury (AKI) in a public hospital in Lagos, Nigeria.MethodsMedical records of all children with AKI managed with PD between July 2010 and March 2013 were reviewed.ResultsSeventeen children with a mean (SEM) age of 3.8 (0.8) years received PD for 0 - 18 days; about half were infants. PD was provided manually, frequently with intercostal drains as catheters. Blockage of catheters and peritonitis occurred in 4 (23.5%) and 2 (11.8%) children, respectively. Eight (47.1%) of the 17 children had resolution of AKI and were discharged from hospital. In 4 (57.1%) of the 7 children who died, PD was performed for ≤ 2 days.ConclusionPD for childhood AKI is feasible in resource-constrained regions with fairly good outcome. Blockage of catheter was the most common complication encountered.

Suicidal Death Autopsy Analysis at Dhaka Medical College

1970 ◽  
Vol 40 (1) ◽  
pp. 18-21 ◽  
Author(s):  
MN Hossain ◽  
Z Rahman ◽  
S Akhter
Keyword(s):  
Forensic Medicine ◽  
Causes Of Death ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Autopsy Report ◽  
Common Causes ◽  
Suicidal Death

A cross sectional study was carried out at the department of Forensic Medicine in Dhaka Medical College during the period of January 2008 to December 2009. Data were collected from 3rd copy of the post mortem reports which were preserved in the department of Forensic Medicine with the verbal consent of the doctors who performed autopsy report. During this period total 5114 autopsies were conducted. Out of this 970 cases (19%) were suicidal in nature. It was noticed that all suicidal deaths occurred from 10 years to all age group respectively, but top amongst age group of suicidal deaths occurred in between 21 to 30 years of people. Suicidal deaths are more common in female than male. Suicidal deaths due to hanging is highest, next common causes of death due to organophosphorus compund poisoning. Suicidal deaths by hanging is more in female than male but in poisoning cases male are more lvictimised than female. Objectives of our study are to see the occurrence and methods of suicidal death. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9957 BMJ 2011; 40(1): 18-21

scholarly journals ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 Update (paediatrics)

2021 ◽  
pp. 089686082098212
Author(s):  
Peter Nourse ◽  
Brett Cullis ◽  
Fredrick Finkelstein ◽  
Alp Numanoglu ◽  
Bradley Warady ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Continuous Flow ◽  
Kidney Injury ◽  
Close Monitoring ◽  
Minimum Standard ◽  
Acceptable Alternative ◽  
Dialysis Solution ◽  
Days Of Therapy ◽  
Dialysis Solutions

Peritoneal dialysis (PD) for acute kidney injury (AKI) in children has a long track record and shows similar outcomes when compared to extracorporeal therapies. It is still used extensively in low resource settings as well as in some high resource regions especially in Europe. In these regions, there is particular interest in the use of PD for AKI in post cardiac surgery neonates and low birthweight neonates. Here, we present the update of the International Society for Peritoneal Dialysis guidelines for PD in AKI in paediatrics. These guidelines extensively review the available literature and present updated recommendations regarding peritoneal access, dialysis solutions and prescription of dialysis. Summary of recommendations 1.1 Peritoneal dialysis is a suitable renal replacement therapy modality for treatment of acute kidney injury in children. (1C) 2. Access and fluid delivery for acute PD in children. 2.1 We recommend a Tenckhoff catheter inserted by a surgeon in the operating theatre as the optimal choice for PD access. (1B) (optimal) 2.2 Insertion of a PD catheter with an insertion kit and using Seldinger technique is an acceptable alternative. (1C) (optimal) 2.3 Interventional radiological placement of PD catheters combining ultrasound and fluoroscopy is an acceptable alternative. (1D) (optimal) 2.4 Rigid catheters placed using a stylet should only be used when soft Seldinger catheters are not available, with the duration of use limited to <3 days to minimize the risk of complications. (1C) (minimum standard) 2.5 Improvised PD catheters should only be used when no standard PD access is available. (practice point) (minimum standard) 2.6 We recommend the use of prophylactic antibiotics prior to PD catheter insertion. (1B) (optimal) 2.7 A closed delivery system with a Y connection should be used. (1A) (optimal) A system utilizing buretrols to measure fill and drainage volumes should be used when performing manual PD in small children. (practice point) (optimal) 2.8 In resource limited settings, an open system with spiking of bags may be used; however, this should be designed to limit the number of potential sites for contamination and ensure precise measurement of fill and drainage volumes. (practice point) (minimum standard) 2.9 Automated peritoneal dialysis is suitable for the management of paediatric AKI, except in neonates for whom fill volumes are too small for currently available machines. (1D) 3. Peritoneal dialysis solutions for acute PD in children 3.1 The composition of the acute peritoneal dialysis solution should include dextrose in a concentration designed to achieve the target ultrafiltration. (practice point) 3.2  Once potassium levels in the serum fall below 4 mmol/l, potassium should be added to dialysate using sterile technique. (practice point) (optimal) If no facilities exist to measure the serum potassium, consideration should be given for the empiric addition of potassium to the dialysis solution after 12 h of continuous PD to achieve a dialysate concentration of 3–4 mmol/l. (practice point) (minimum standard) 3.3  Serum concentrations of electrolytes should be measured 12 hourly for the first 24 h and daily once stable. (practice point) (optimal) In resource poor settings, sodium and potassium should be measured daily, if practical. (practice point) (minimum standard) 3.4  In the setting of hepatic dysfunction, hemodynamic instability and persistent/worsening metabolic acidosis, it is preferable to use bicarbonate containing solutions. (1D) (optimal) Where these solutions are not available, the use of lactate containing solutions is an alternative. (2D) (minimum standard) 3.5  Commercially prepared dialysis solutions should be used. (1C) (optimal) However, where resources do not permit this, locally prepared fluids may be used with careful observation of sterile preparation procedures and patient outcomes (e.g. rate of peritonitis). (1C) (minimum standard) 4. Prescription of acute PD in paediatric patients 4.1 The initial fill volume should be limited to 10–20 ml/kg to minimize the risk of dialysate leakage; a gradual increase in the volume to approximately 30–40 ml/kg (800–1100 ml/m2) may occur as tolerated by the patient. (practice point) 4.2 The initial exchange duration, including inflow, dwell and drain times, should generally be every 60–90 min; gradual prolongation of the dwell time can occur as fluid and solute removal targets are achieved. In neonates and small infants, the cycle duration may need to be reduced to achieve adequate ultrafiltration. (practice point) 4.3 Close monitoring of total fluid intake and output is mandatory with a goal to achieve and maintain normotension and euvolemia. (1B) 4.4 Acute PD should be continuous throughout the full 24-h period for the initial 1–3 days of therapy. (1C) 4.5  Close monitoring of drug dosages and levels, where available, should be conducted when providing acute PD. (practice point) 5. Continuous flow peritoneal dialysis (CFPD) 5.1   Continuous flow peritoneal dialysis can be considered as a PD treatment option when an increase in solute clearance and ultrafiltration is desired but cannot be achieved with standard acute PD. Therapy with this technique should be considered experimental since experience with the therapy is limited. (practice point) 5.2  Continuous flow peritoneal dialysis can be considered for dialysis therapy in children with AKI when the use of only very small fill volumes is preferred (e.g. children with high ventilator pressures). (practice point)

Sign in / Sign up

Export Citation Format

Share Document