Improvised peritoneal dialysis on a G-6-PD deficient child with acute kidney injury: maiden experience in Umuahia, South Eastern Nigeria.

Abstract

Background: Management of acute kidney injury (AKI) has remained a daunting challenge with significant mortality, especially in the developing countries where facilities for renal replacement therapy (RRT) are limited and usually not affordable. We present this case of AKI managed with improvised peritoneal dialysis with a successful outcome as the first peritoneal dialysis in our facility, Federal Medical Centre, Umuahia.     

 Case summary: A 2 year old G-6-PD deficient male was referred to us with hemoglobinuria, pallor and jaundice which he developed following treatment with antimalarial drug (amodiaquine). He subsequently developed features of AKI with body swelling, hypertension, serum creatinine level of 5.6mg/dl and serum urea of 159.5mg/dl. Urine flow rate ranged from 0.4-1.2mls/kg/hour. Bedside urinalysis showed protein (2+) and blood (2+). The patient had 14 sessions of PD over 4 days with significant clinical and biochemical improvement.  

Conclusion: In settings where standard materials for peritoneal dialysis are not available as is common in resource-poor countries, improvised peritoneal dialysis can be offered to children with AKI.