Challenges and Outcomes of Paediatric Dialysis in a Tertiary Referral Hospital, Northwest Nigeria.

BACKGROUND

Acute kidney injury (AKI) is associated with substantial morbidity, requiring urgent intervention like dialysis. Dialysis is usually paid for out of pocket, posing a high financial burden on the caregivers. This usually leads to irregular dialysis sessions and a high rate of abandonment of dialysis with consequent high morbidity and mortality. The objective of this study is to assess the clinical profile, challenges and outcomes of dialysis in children with AKI at a tertiary referral hospital.

METHODOLOGY: An observational descriptive study involving 55 children admitted with Acute Kidney Injury who had dialysis as a form of renal replacement therapy. The data were collected as the patients presented to the study center.

RESULTS

Out of 55 patients recruited, 41 (74.5%) were referred by other healthcare facilities. Sepsis accounted for 54.6% of the causes of AKI. Thirty-nine (70.9%) of the patients underwent haemodialysis (HD), while 29.1% underwent Peritoneal dialysis (PD). Seven (12.7%) abandoned dialysis, 24(43.6%) died, and 22(40.0%) had resolution of AKI. Severe financial difficulties were experienced by 36(65.5%) of patients, which was significantly related to the poor outcome of the patients.

CONCLUSION

Financial support mechanisms, early referral pathways, and the availability of paediatric-specific dialysis equipment could substantially improve survival outcomes in children with AKI in low-resource settings.