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Dialysis is a type of renal replacement therapy (RRT) employed to maintain the excretory function of a failed kidney. Haemodialysis is the most common form of dialysis offered worldwide and in Nigeria, with acute haemodialysis being the most commonly accessed modality of RRT.
It was a case series retrospective observational study of a prospective clinical database of children admitted into the paediatric ward of Federal Medical Center, Asaba, South South Nigeria, and who accessed haemodialysis during the course of their management in the Paediatric nephrology unit, from November 2016 to October 2022 (6 years).
There were 78 patients admitted and managed by the nephrology unit during the study period, 37.2% required RRT and 69.0% accessed it: of which were 55% females, 80% adolescents, 55% with acute kidney injury (AKI). The median age at initiation of RRT was 12 years. Patient requiring haemodialysis (HD) for AKI were majorly those with nephrotic syndrome while most of those with chronic kidney disease (CKD) were of unknown aetiology. All patients had multiple indications for HD but most frequent was anuria. Patient with AKI were younger and pericardial effusion was a more common indication for HD in patients with CKD. Inpatient case fatality rate was 25% but the total mortality during the follow up period was 50%. The presence of encephalopathy as indication for HD was associated with increased mortality. .
Nephrotic syndrome was the most common aetiology of AKI requiring RRT while pericardial effusion was a more common indication for HD in patients with CKD. Encephalopathy was a poor prognostic factor in RRT in our facility.