Peritoneal Dialysis in an Infant with Severe Acute Kidney Injury: Dialysis Performed In-Flight During a Medical Evacuation in French Guiana – A Case Report

Abstract

We report the case of a 7-month-old infant presenting with severe acute kidney injury in the context of respiratory infection and dehydration who was managed in French Guiana, an isolated territory with limited medical resources. Automated peritoneal dialysis was initiated early, leading to rapid clinical improvement. Due to the necessity of medical evacuation to a referral center, continuity of treatment was maintained aboard a commercial flight from Cayenne to Paris (duration 8 hours 30 minutes) through the performance of three manual exchanges of ambulatory continuous peritoneal dialysis. These exchanges were conducted by a multidisciplinary team (pediatrician, adult nephrologist, nurse) with the assistance of the infant’s mother using an improvised setup that adhered strictly to aseptic protocols. This case highlights the feasibility, safety, and strategic importance of peritoneal dialysis in extreme pediatric settings and constrained environments.