Peritoneal Dialysis in Children with Acute Renal Failure in Ibn Al-Balady Hospital

Department of Pediatrics , Dialysis unit , Ibn AlBalady Hospital for pediatrics & gynecology , Baghdad. years , the use of continuous renal replacement therapy (CRRT) has been increasingly preferred over peritoneal dialysis (PD) for the pediatric population in most centers in the developed world (3,4) , however , in developing countries , PD remains a viable option for the treatment of children with acute renal failure , particularly in patients with hemodynamically compromise , sever coagulation abnormalities , difficult obtaining vascular access especialy small children and in availibilty of blood lines compatible with neonates or young infants(2 8).In this study I wish to record the experience of PD for children admitted to dialysis unit in Ibn Al-Balady hospital for the period since opening of this unit in August 2011 until April 2014. ABSTRACT: BACKGROUND : Acute renal failure (ARF) is most important condition in pediatric nephrology units with variable causes vary from place to place and peritoneal dialysis(PD) is the easy and feasible modality of treatment for acute renal failure in small and young children and hemodynamically unstable patients were other modalities not suitable for them. OBJECTIVE: To stady the aetiology and prognosis of the patients with acute renal that required peritoneal dialysis in ibn al balady hospital. METHODS: A retrospective study involved 82 patients with acute renal failure admitted to dialysis in Ibn Al-Balady hospital for a period of 32 months from August 2011 to April 2014 . Data were collected from patients records and involved clinical parameters of the patients, causes of ARF , indications of PD ,complications of PD and the outcome of PD(deaths). RESULTS : The study involved 82 children of whom 47(57.3%) male ,with a mean age of 13 +19.5 months . Azotemia was presented in all patients (100%) with oliguria in 60(73.2%) or unuria in 26 pateints (31.7%) , volume overlaod in 32(39%) , encephalopathy in 28 pateints (32.9%). Sepsis was the most common cause of ARF in 32 pateints (39%) while gastroentritis in 16 pateints (19.5%) , glomerulonephritis in 10 pateints (12.2%) and hemolytic uremic syndrome ( HUS) in 9 pateints (11%). Peritonitis is the commenest complication of PD represents 33(40.2%) of pateints. The overall mortality was 32.9 % mostly related to septicemia (63%) and the presence of fluid overlaod, peritonitis,encephalopathy and unuria (66.7,66.7,63 and 59.3% ) respectivly. CONCLUSION : Peritoneal dialysis is the preferred modality of renal replacement therapy (RRT) for children with acute renal failure( ARF) because its simple and feasible especially neonates and young infants and hemodynamically unstable patients. Septicemia and severity of ARF are contributory factors to high mortality in pediatric ARF.Early detection and referral of patients at risk is of great value for reducing mortality.