article · BMC Nephrology
Acute peritoneal dialysis serves as an essential renal replacement therapy for children experiencing acute kidney injury in resource-constrained environments. At Kenyatta National Hospital in Nairobi, Kenya, clinical records and laboratory measurements were evaluated for 64 paediatric patients initiating peritoneal dialysis over a five-month period. The enrolled children had a median age of 18 days, with sick neonates showing a higher vulnerability to acute kidney injury than older children. Measurements taken before and after the initial 24 hours of dialysis demonstrated a statistically significant reduction in average serum urea and creatinine levels. The treatment achieved a median daily creatinine clearance of 5.13 litres per day per 1.73 square metres alongside a median daily urea clearance of 1.03, confirming that acute peritoneal dialysis delivers measurable solute clearance in this clinical environment.
Acute kidney injury in children can cause prolonged hospital stays and high mortality if dialysis is inadequate. By assessing urea and creatinine clearance in a resource-limited referral hospital, this research provides baseline evidence on real-world dialysis adequacy. Understanding these clearance rates helps clinicians evaluate whether standard peritoneal dialysis protocols sufficiently clear toxins in critically ill newborns and infants when alternative therapies are unavailable.
The abstract does not evaluate a proprietary device or product, focusing instead on observational clinical clearance data from existing hospital treatments. Potential practical applications lie in informing paediatric dialysis prescription protocols or dosing guidelines for public hospital nephrology units. Because the work is observational clinical research rather than product development, any commercial or operational translation, such as clinical decision-support software for fluid prescriptions, remains at a very early conceptual stage.
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Abstract Background: Acute peritoneal dialysis (PD) is an important renal replacement therapy for children with acute kidney injury (AKI), particularly in resource-limited settings. Inadequate PD may result in persistent uremia, prolonged hospitalization, increased mortality, and transition to hemodialysis. Dialysis adequacy is commonly assessed using urea and creatinine clearance, which are influenced by prescription parameters such as fill volume, dwell time, and dialysate dextrose concentration. However, there is limited data on target clearance values for children undergoing acute PD. This study aimed to assess PD adequacy and describe urea and creatinine clearance among children receiving acute PD at a national referral hospital in Kenya. Methods: A cross-sectional study was conducted at Kenyatta National Hospital, a teaching and referral hospital in Nairobi, Kenya. We enrolled children who were starting peritoneal dialysis over a period of 5 months in the paediatric renal unit. Records of total drain volumes and serum and effluent concentrations of electrolytes, urea, and creatinine before and after 24 hours of dialysis were obtained via questionnaires. Daily urea and creatinine clearance were calculated for each child. A paired t-test was used to compare mean serum urea and creatinine concentrations before and after the first 24 hours of dialysis because measurements were obtained from the same participants and the data was approximately normally distributed. Descriptive analysis was used to compare solute clearance between groups of dialysate dextrose concentrations. Results: 64children were enrolled at a median age of 18days, and 43% were female. The median daily creatinine clearance was 5.13 L/day/1.73m 2 , and the median daily urea clearance was 1.03. There was a statistically significant reduction in mean serum urea and creatinine after the first day of dialysis. Sick neonates were at a higher risk of developing AKI than infants and older children. Conclusion: Peritoneal dialysis achieved measurable clearance of urea and creatinine among patients admitted to the paediatric renal unit at Kenyatta National Hospital.
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DOI: 10.1186/s12882-026-05338-6
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