ArticlePediatric nephrology (Berlin, Germany)2024
Dialysis for paediatric acute kidney injury in Cape Town, South Africa.
Article in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Key performance indicators for acute kidney replacement therapy in critically ill children: a systematic review.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Outcomes of pediatric urgent-start peritoneal dialysis: a single-center experience from Jordan.Renal failure · 2026Article
- Article
- Epidemiology and outcome of pediatric acute kidney injury-multicenter observational study from a low-middle-income country.Pediatric nephrology (Berlin, Germany) · 2025Observational
- Innovation of a Neonatal Peritoneal Dialysis Catheter to Expand Dialysis Capabilities for Critically Ill Neonates in Low-Resource Settings.Blood purification · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
15 authors.
Funding
Abstract
backgroundDialysis is lifesaving for acute kidney injury (AKI), but access is poor in less resourced settings. A "peritoneal dialysis (PD) first" policy for paediatric AKI is more feasible than haemodialysis in low-resource settings.
methodsRetrospective review of modalities and outcomes of children dialysed acutely at Red Cross War Memorial Children's Hospital between 1998 and 2020.
resultsOf the 593 children with AKI who received dialysis, 463 (78.1%) received PD first. Median age was 9.0 (range 0.03-219.3; IQR 13.0-69.6) months; 57.6% were < 1 year old. Weights ranged from 0.9 to 2.0 kg (median 7.0 kg, IQR 3.0-16.0 kg); 38.6% were < 5 kg. PD was used more in younger children compared to extracorporeal dialysis (ECD), with median ages 6.4 (IQR 0.9-30.4) vs. 73.9 (IQR 17.5-113.9) months, respectively (p = 0.001). PD was performed with Seldinger soft catheters (n = 480/578, 83%), predominantly inserted by paediatricians at the bedside (n = 412/490, 84.1%). Complications occurred in 127/560 (22.7%) children receiving PD. Overall, 314/542 (57.8%) children survived. Survival was significantly lower in neonates (< 1 month old, 47.5%) and infants (1-12 months old, 49.2%) compared with older children (> 1 year old, 70.4%, p < 0.0001). Survival was superior in the ECD (75.4%) than in the PD group (55.6%, p = 0.002).
conclusions"PD First for Paediatric AKI" is a valuable therapeutic approach for children with AKI. It is feasible in low-resourced settings where bedside PD catheter insertion can be safely taught and is an acceptable dialysis modality, especially in settings where children with AKI would otherwise not survive.
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