Anjum Saeed, Muhammad Yaqoob, Muhammad Khalid Masood, Farkhanda Hafeez, Tahira S Izhar, Atta Ullah.
Peritoneal dialysis; indication, efficacy and acute complications.
Pak Paed J Jan ;29(3):121-8.

Objective: The objectives of this study were to find out indications, complications, and effectiveness of peritoneal dialysis. Design: Observational Setting: This study was done in Nephrology department, paediatric emergency section, and paediatric ICU at CH & ICH, over a period of six moths from June to December 2003. This study included 50 patients. Results: Total of 50 patients were studied. 74% had chronic renal failure and 26% had acute renal failure. Male dominated, 62% compared to females 38%. The common causes of acute renal failure were sepsis and Hemolytic Uremic syndrome. In chronic renal failure (CRF) group the common causes were congenital structural anomalies followed by glomerulopathies.Indications of peritoneal dialysis were fluid overload 26%, acidosis 26%, uremia 24%, hypertension 16%, hyperkalemia 8% and absolute Anuria 4%. Pre-dialysis biochemical values were, mean blood pH (6.98 + 0.18), blood urea (163.70 + 93.79), serum creatinine (9.33 ± 3.46), serum sodium (136.70 + 4.89), serum potassium (4.90 + 1.40), serum calcium (6.99 + 0.65) mmol/L. After dialysis; changes in biochemical profile were blood pH (7.21 + 0.10), blood urea (75.22 + 54.26), serum creatinine (4.83 + 2.77), serum sodium (135.90 + 3.92) and serum calcium (7.07 + 0.78) mmol/L. These biochemical parameters were analyzed statistically by applying student t test. Except serum calcium all other biochemical parameters improved and were statistically significant ( p value < 0.000 to 0.001). Mean improvement time in patients undergone dialysis was 20 hours (fluid overload), 30 hours (acidosis and hyperkalemia), 52 hours (hypertensive encephalopathy) and 70 hours (uremic encephalopathy). Complications noted during peritoneal dialysis were pain abdomen, catheter related, febrile reactions, fluid and electrolytic imbalance, peritonitis and gut perforation in decreasing frequency. Among 50 study case, 74% improved, 12% expired, and 6% did not improve and the shifted to hemodiaiysis.

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