Risk Factors Associated with Outcome of Peritoneal Dialysis and Hemodialaysis Done for Patient with Acute Kidney Injury in Tikur Anbessa Hospital Pediatrics Intensive Care Unit From January 2018 To Dec 2023.
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Date
2024-04
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Addis Ababa University
Abstract
Back ground: Acute kidney injury is an abrupt loss of kidney function that results in a decline in glomerular filtration rate, retention of urea and other nitrogenous waste products, and deregulation of extracellular volume and electrolytes The AKI is a serious condition, with a multi factorial etiology In numerous cases, and with variable mortality, reaching further than 60% in patient who took dialysis. Morbidity and mortality is especially high in sub-Saharan Africa whereaccess to dialysis is veritably limited. Identifying modifiable risk factor associated with outcomeof dialysis may improve the outcome Objective: - To identify the risk factors associated with the outcomes of HD and PD among patient with acute kidney injury at Tikure Anbessa hospital pediatric intensive care unit from Jan 2018 to Dec 2023
Method:-a retrospective cohort study will be conducted on risk factors associated withoutcomes of hemodyalisis and peritoneal dialysis done for patient with AKI in TASH PICU fromJan 2018 to Dec 2023 with structured questionnaire to collect the data from the patients’ card.Data checked, gutted and Inputted into SPSS interpretation 27.0 software version for analysis. P values of (P <0.005) will be considered statistically significant. Paired t test was used tocompare blood biochemistry before initiation and at the end of dialysis and Multinomial logisticregression was used to determine the relation between the different independent variables to final outcome.
Results:-there were 30 children in this study Most of patient were male in 56.7% .Most of the cases who undertake peritoneal dialysis were less than 5 years (59.1%) whereas greater than 10 years for those who took hemodyalisis .The majority were from outside of Addis Ababa which is 24 (80%) . The highest cause of AKI was RPGN in 20 (66.6%) from this PSGN was the cause in 50% but the remaining cause of RPGN was not identified, followed by ATN and lupus nephritis each in (10%) HUS in (6.5%), malignancy and ATIN each in (3.3%).there is astatistically significant mean difference on serum BUN, creatinine and potassium beforeinitiation and after the last dialysis with P value of (P< 0.001). In hospital mortality rate was in40% and low urine output was significantly associated with mortality with P value of (P< 0.037). In these study most of peritoneal dialysis was done with locally prepared solution with Ringer lactate and Dextrose and Hemodyalisis was done on adult side.Complication encountered in 17 (56.7%) of patients from this 13 (60%) associated with peritoneal dialysis and 4 (50%) associated with hemodyalisis Most common complication associated with peritoneal dialysis were catheter leakage 6 (26%) then followed by catheter blockage 5 (21.7%) and peritonitis in 5 (21.7% ), omental herniation 2(8.6%), hyperglycemia 2(8.6%) presence of complication was not associated with mortality with P value of 0.9
Conclusion:-our finding revealed that majority of pediatrics AKI patients had successful restoration of kidney function after dialysis which was comparable to other study. Low urine output at the end of dialysis was the independent predictor for death, which was supported by other study. In poor resource setting like in our country improvised peritoneal dialysis was safe and effective method to manage pediatrics AKI. It is recommended to have more trained medical staff in pediatrics Nephrology and extending PD service to other parts of the country. It is recommended to conduct well-structured prospective study including the other referral hospital in the country with adequate sample size to better assess the outcome of dialysis
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Kidney injury