Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 4 2020
Acute Pediatric Peritoneal Dialysis: Impact of An Opt-Out Model and Adaptable Methods in A Hospital in Nigeria
Dublin Core
Title
Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 4 2020
Acute Pediatric Peritoneal Dialysis: Impact of An Opt-Out Model and Adaptable Methods in A Hospital in Nigeria
Acute Pediatric Peritoneal Dialysis: Impact of An Opt-Out Model and Adaptable Methods in A Hospital in Nigeria
Subject
acute kidney injury, less developed countries, opt-out model, peritoneal dialysis
Description
BACKGROUND Despite efforts to scale peritoneal dialysis (PD) uptake, access is still limited in Sub-Saharan Africa, including Nigeria. Thus, this study evaluated access to PD, cost-effectiveness, complications, and in-hospital mortality rate following the adoption of a local opt-out model approach for all children with acute kidney injury (AKI) that required PD.
METHODS This work was a retrospective review of 33 children with AKI that required dialysis between December 2014 and November 2016. PD was carried out using locally adaptable consumables in place of commercially produced consumables. All patients that required renal replacement therapy (RRT) were offered an option to opt-out irrespective of their financial status. Patients’ relevant data were retrieved from the case notes and analyzed.
RESULTS The median age was 7 years (range 3–12). 23 patients (70%) were males. Of the 33 patients that required RRT, 29 had PD. The children had an access rate of 88% (95% CI = 76.77–99.03). The access rate was not related to gender (p = 1.000), age group (p = 0.240), or socioeconomic status (p = 0.755). Complications were pericatheter leakage
of fluid (n = 7, 24%), catheter malfunction (n = 5, 17%), abdominal wall edema (n = 3, 10%), scrotal edema (n = 2, 7%), and peritonitis (n = 1, 3%). In-hospital mortality was 3/29 (10%; 95% CI = 2.2–27.3). Cost analysis revealed that the cost of consumables was reduced by 88.5%.
CONCLUSIONS An opt-out model with the use of locally adaptable consumables improved PD access (88%) with a low in-hospital mortality rate.
METHODS This work was a retrospective review of 33 children with AKI that required dialysis between December 2014 and November 2016. PD was carried out using locally adaptable consumables in place of commercially produced consumables. All patients that required renal replacement therapy (RRT) were offered an option to opt-out irrespective of their financial status. Patients’ relevant data were retrieved from the case notes and analyzed.
RESULTS The median age was 7 years (range 3–12). 23 patients (70%) were males. Of the 33 patients that required RRT, 29 had PD. The children had an access rate of 88% (95% CI = 76.77–99.03). The access rate was not related to gender (p = 1.000), age group (p = 0.240), or socioeconomic status (p = 0.755). Complications were pericatheter leakage
of fluid (n = 7, 24%), catheter malfunction (n = 5, 17%), abdominal wall edema (n = 3, 10%), scrotal edema (n = 2, 7%), and peritonitis (n = 1, 3%). In-hospital mortality was 3/29 (10%; 95% CI = 2.2–27.3). Cost analysis revealed that the cost of consumables was reduced by 88.5%.
CONCLUSIONS An opt-out model with the use of locally adaptable consumables improved PD access (88%) with a low in-hospital mortality rate.
Creator
Michael Abel Alao, Olayinka Rasheed Ibrahim, Olajide Olusegun Abiola, Daniel Adedosu Gbadero, Adanze Onyenonachi Asinobi
Publisher
Fakultas Kedokteran Universitas Indonesia
Date
2021-01-01
Contributor
Sri Wahyuni
Rights
ISSN : 0853-1773
Format
PDF
Language
English
Type
Text
Coverage
Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 4 2020
Files
Citation
Michael Abel Alao, Olayinka Rasheed Ibrahim, Olajide Olusegun Abiola, Daniel Adedosu Gbadero, Adanze Onyenonachi Asinobi, “Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 4 2020
Acute Pediatric Peritoneal Dialysis: Impact of An Opt-Out Model and Adaptable Methods in A Hospital in Nigeria,” Repository Horizon University Indonesia, accessed April 18, 2025, https://repository.horizon.ac.id/items/show/921.
Acute Pediatric Peritoneal Dialysis: Impact of An Opt-Out Model and Adaptable Methods in A Hospital in Nigeria,” Repository Horizon University Indonesia, accessed April 18, 2025, https://repository.horizon.ac.id/items/show/921.