ESPN 51th Annual Meeting

ESPN 2018


 
First experience of paediatric acute peritoneal dialysis program in the Democratic Republic of Congo
EKULU PEPE M. 1 Yoli M Ndiyo 2 Orly K. Kazadi 2 Dieumerci K. Betukumesu 2 Agathe B. Nkoy 2 E Levtchenko 1 B. Lepira Fran├žois 3

1- DEPARTMENT OF PAEDIATRIC NEPHROLOGY & GROWTH AND REGENERATION, UNIVERSITY HOSPITALS LEUVEN KU LEUVEN - UNIVERSITY OF LEUVEN, LEUVEN, BELGIUM
2- Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo
3- Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo
 
Introduction:

 The Democratic Republic of Congo (DRC) is one of the most challenging environments for health development in sub-Saharan Africa (SSA). Indeed, child mortality in the DRC is one of the highest in Africa.

Material and methods:

In the DRC, renal disease is often a fatal complication of the most common diseases of childhood, both acute (malaria, diarrhea, sepsis) and chronic (HIV infection, sickle cell anaemia)The acute kidney injury (AKI) contributes significantly to this high rate of child mortality because of the conjunction of poverty, the lack of  pediatric dialysis programs and the deficiency of qualified health care providers in pediatric renal diseases.

 

In order to reduce preventable deaths by optimizing the treatment of AKI, a team composed of one physician and one nurse from the pediatric nephrology department of the University Hospital of Kinshasa has been recently trained at the University Hospital of Cotonou with the joint support of the KU Leuven through the VLIR Project and the Saving Young Lives (SYL) program, a complementary partnership between 3 international nephrology organizations: International Society of Nephrology (ISN), International Pediatric Nephrology Association (IPNA), International Society for Peritoneal Dialysis (ISPD). The training consisted of learning all aspects of acute peritoneal dialysis (PD) and especially focused on two useful techniques for low income countries namely on bedside PD catheter insertion and the local production of PD fluids.

Results:

 Upon the return from training, in December 2017, pediatric PD activities have started, remarkably at a very low cost. Up to now, 5 children with AKI mainly due to malaria and sepsis were eligible to dialysis. There were 3 boys and 2 girls with the median age of 6 years (range 2-12 years). The main indications of dialysis were prolonged anuria with fluid overload and uremic toxicity. Despite the low socioeconomic status of parents, all children have been successfully dialyzed, without any complication and recovered their renal function after an average of 6 days of PD treatment.

Conclusions:

 This promising experience reveals the importance of South-South cooperation with the support of the Northern partners. The final goal of this program is to extend the training to practitioners in other provinces of the country in order to contribute significantly to the 0by25 objective of the ISN.