Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria
A 5-year observational, retrospective study was conducted to evaluate the indications, the availability, the accessibility, the sustainability, and the outcome of children managed for acute kidney injury (AKI) and end stage kidney disease (ESKD) who required renal replacement therapy RRT in Enugu, s...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2014/903151 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832548999079395328 |
|---|---|
| author | Odutola Israel Odetunde Henrietta Uche Okafor Samuel Nkachukwu Uwaezuoke Bertilla Uzoma Ezeonwu Oluchi Mildred Ukoha |
| author_facet | Odutola Israel Odetunde Henrietta Uche Okafor Samuel Nkachukwu Uwaezuoke Bertilla Uzoma Ezeonwu Oluchi Mildred Ukoha |
| author_sort | Odutola Israel Odetunde |
| collection | DOAJ |
| description | A 5-year observational, retrospective study was conducted to evaluate the indications, the availability, the accessibility, the sustainability, and the outcome of children managed for acute kidney injury (AKI) and end stage kidney disease (ESKD) who required renal replacement therapy RRT in Enugu, southeast Nigeria. A total of 64 patients aged 5 months to 16 years required RRT, of which only 25 underwent RRT, giving an RRT accessibility rate of 39.1%. Eleven (44%) patients required chronic dialysis program/ renal transplant, of which only 1 (9.1%) accessed and sustained chronic hemodialysis, giving a dialysis acceptance rate of 9.1%. Fifty (78%) of the patients belonged to the low socioeconomic class. Thirty-three (51.5%) could not access RRT because of financial constraints and discharge against medical advice (DAMA); 6 (9.4%) died on admission while sourcing for funds to access the therapy; 5 (7.8%) died while on RRT; 9 (14.1%) improved and were discharged for follow-up; 1 (1.6%) improved and was discharged to be on chronic dialysis program while awaiting renal transplantation outside the country/clinic follow-up, while the remaining 10 (15.6%) were unable to sustain chronic dialysis program or access renal transplantation and were lost to follow-up. We conclude that RRT remains unaffordable within the subregion. |
| format | Article |
| id | doaj-art-8db5b6f871af42d29d8306725720d359 |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-8db5b6f871af42d29d8306725720d3592025-02-03T06:12:28ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/903151903151Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast NigeriaOdutola Israel Odetunde0Henrietta Uche Okafor1Samuel Nkachukwu Uwaezuoke2Bertilla Uzoma Ezeonwu3Oluchi Mildred Ukoha4Pediatric Nephrology Unit, Department of Pediatrics, University of Nigeria Teaching Hospital, PMB 01129, Enugu 400001, NigeriaPediatric Nephrology Unit, Department of Pediatrics, University of Nigeria Teaching Hospital, PMB 01129, Enugu 400001, NigeriaPediatric Nephrology Unit, Department of Pediatrics, University of Nigeria Teaching Hospital, PMB 01129, Enugu 400001, NigeriaDepartment of Pediatrics, Federal Medical Centre, Asaba 320212, Delta State, NigeriaDepartment of Pediatrics, Enugu State University Teaching Hospital, Enugu 400261, Enugu State, NigeriaA 5-year observational, retrospective study was conducted to evaluate the indications, the availability, the accessibility, the sustainability, and the outcome of children managed for acute kidney injury (AKI) and end stage kidney disease (ESKD) who required renal replacement therapy RRT in Enugu, southeast Nigeria. A total of 64 patients aged 5 months to 16 years required RRT, of which only 25 underwent RRT, giving an RRT accessibility rate of 39.1%. Eleven (44%) patients required chronic dialysis program/ renal transplant, of which only 1 (9.1%) accessed and sustained chronic hemodialysis, giving a dialysis acceptance rate of 9.1%. Fifty (78%) of the patients belonged to the low socioeconomic class. Thirty-three (51.5%) could not access RRT because of financial constraints and discharge against medical advice (DAMA); 6 (9.4%) died on admission while sourcing for funds to access the therapy; 5 (7.8%) died while on RRT; 9 (14.1%) improved and were discharged for follow-up; 1 (1.6%) improved and was discharged to be on chronic dialysis program while awaiting renal transplantation outside the country/clinic follow-up, while the remaining 10 (15.6%) were unable to sustain chronic dialysis program or access renal transplantation and were lost to follow-up. We conclude that RRT remains unaffordable within the subregion.http://dx.doi.org/10.1155/2014/903151 |
| spellingShingle | Odutola Israel Odetunde Henrietta Uche Okafor Samuel Nkachukwu Uwaezuoke Bertilla Uzoma Ezeonwu Oluchi Mildred Ukoha Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria The Scientific World Journal |
| title | Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria |
| title_full | Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria |
| title_fullStr | Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria |
| title_full_unstemmed | Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria |
| title_short | Renal Replacement Therapy in Children in the Developing World: Challenges and Outcome in a Tertiary Hospital in Southeast Nigeria |
| title_sort | renal replacement therapy in children in the developing world challenges and outcome in a tertiary hospital in southeast nigeria |
| url | http://dx.doi.org/10.1155/2014/903151 |
| work_keys_str_mv | AT odutolaisraelodetunde renalreplacementtherapyinchildreninthedevelopingworldchallengesandoutcomeinatertiaryhospitalinsoutheastnigeria AT henriettaucheokafor renalreplacementtherapyinchildreninthedevelopingworldchallengesandoutcomeinatertiaryhospitalinsoutheastnigeria AT samuelnkachukwuuwaezuoke renalreplacementtherapyinchildreninthedevelopingworldchallengesandoutcomeinatertiaryhospitalinsoutheastnigeria AT bertillauzomaezeonwu renalreplacementtherapyinchildreninthedevelopingworldchallengesandoutcomeinatertiaryhospitalinsoutheastnigeria AT oluchimildredukoha renalreplacementtherapyinchildreninthedevelopingworldchallengesandoutcomeinatertiaryhospitalinsoutheastnigeria |