Management of acute kidney injury with encephalopathy in a 5-year old male using improvised peritoneal dialysis in University of Uyo Teaching Hospital, Uyo, Nigeria: A Case report

Abstract

Acute kidney injury (AKI) has become increasingly prevalent in both resource rich and resource poor countries and is associated with significantly higher morbidity and mortality in the later, where access to renal replacement therapy (RRT) is poor. Peritoneal Dialysis (PD) is a well acknowledged and established form of RRT and it appears to be the most practical modality in young children with AKI in such countries. PD, though a cheaper alternative to haemodialysis (HD), is still challenging and unaffordable due to complex problems like lack of standard PD catheters and dialysate fluid, poor access to health facilities for rural dwellers, late presentations to health facilities and pervasive poverty. With some ingenuity, cheaper and more widely available alternatives like improvised catheters e.g. nasogastric tube, rubber catheter, intercostal drainage catheter, haemodialysis catheters and self-constituted fluid e.g. fortified ringers lactate, 0.9% sodium chloride with modified sodium lactate can been used with success. In this article, we share our experience on how acute PD was carried out successfully in a five-year old male with AKI complicated by uraemic encephalopathy, using improvised peritoneal dialysis and self-constituted PD solution in a place where standard renal re- placement therapy does not exist.