Haemodialysis Treatment among Children with Kidney failure in North-Western Nigeria: A Three-Year Review

Abstract

Background: Chronic kidney disease (CKD) is on the increase worldwide and leading to a rise in the number of children requiring renal replacement therapy (RRT). Optimal management of these children continues to be a challenge in resource-limited settings where majority has no access to any form of RRT. This study reviews the clinical and laboratory characteristics of children who had haemodialysis at Aminu Kano Teaching Hospital (AKTH) over a three-year period.
Materials and Methods: The case notes and dialysis records of all children who had undergone haemodialysis from December 2008 to December 2011 were reviewed. Information retrieved included their ages at presentation, blood pressures, laboratory characteristics on admission, time to initiation of dialysis and frequency of dialysis sessions.
Results: Twenty-eight children underwent haemodialysis during the period. The age range was 6 to 15 years with a mean age of 11.8 years. Twenty children (71.4%) had chronic kidney disease and 8 (28.6%) had acute kidney injury. The mean serum urea concentration was 34.5mmol/L (range: 17.6 – 68.4) while the mean serum creatinine concentration was 1202.4µmol/L (range: 758 – 2564) on admission. Twenty-three children (82.1%) had severe anaemia
at presentation. The average duration of time from admission to commencement of dialysis was 6 days (range: 2 – 11 days). Of the children with CKD, only two (10%) could afford more than 2 haemodialysis sessions per week. No patient had renal transplantation.
Conclusion: Haemodialysis in children continues to be a challenge in resource-limited settings. Most children present late, with poor outcomes. Early referral and improved health insurance systems may help overcome these problems.