IP International Journal of Medical Paediatrics and Oncology


Effect of peritoneal dialysis on malarial AKI children: a cross sectional study


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Author Details: Nihar Ranjan Mishra, Prakash Chandra Panda, Sarthak Ranjan Nayak

Volume : 2

Issue : 2

Online ISSN : 2581-4702

Print ISSN : 2581-4699

Article First Page : 46

Article End Page : 50


Abstract

Background: Peritoneal dialysis (PD) is the main stream of treatment as renal replacement therapy in pediatric patients with AKI in developing countries. Acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults, but its incidence, prevalence and clinical importance in paediatric medicine not well documented.
Objectives: To find out the effect of peritoneal dialysis on outcome of malarial AKI children in a tertiary care centre.
Methods: A cross-sectional study done in under 14 children suffering from severe malaria (SM). Neonates, children with associated pre-existing renal disease or having chronic kidney disease (CKD) or acute on CKD and known hypertensives were excluded. All the enrolled children were screen for AKI as per KDIGO guidelines & categorised in two three stages. PD was done as per the predefined criteria& all relevant data were analysed with computer generated software.
Results: Out of 406 SM cases, AKI detected in 15% with female predominance Mortality among renal failure patients is 26.67%. PD required in 52.0% of patients & mortality rate of 25.0% in KDIGO stage I, II but 55.0% in KDIGO Stage III significance(p=0.000). There is a significant correlation between pre dialysis & post dialysis serum urea/ creatinine/ potassium/ TPC & urine output (p = 0.000).
Conclusion: AKI is an under-recognized complication in young kids with SM and is related to enhanced acute/ long-term morbidity & mortality. Its early detection & intervention by peritoneal dialysis improves the same.

Keywords
: Severe malaria (SM), Acute Kidney Injury (AKI), Peritoneal dialysis(PD), KDIGO(Kidney Disease: Improving Global Outcome) guidelines, Chronic, Kidney Disease(CKD)