Paediatric acute kidney injury management in an African setting

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dc.contributor.advisorAndrew, Argent
dc.contributor.advisorMorrow, Brenda
dc.contributor.advisorLuyckx, Valerie
dc.contributor.authorMc, Culloch Mignon
dc.date.accessioned2025-09-11T12:23:53Z
dc.date.available2025-09-11T12:23:53Z
dc.date.issued2025
dc.date.updated2025-09-11T12:15:47Z
dc.description.abstractKidney disease is a growing public health concern, affecting adults but also children who face challenges of access in low-resource settings including Africa. We studied our own paediatric dialysis results, our fellows training in the field of acute kidney injury (AKI) and reviewed innovative techniques for acute peritoneal dialysis, which also included costing of forms of acute dialysis in children. Dialysis for Paediatric AKI in Cape Town, South Africa A review of our dialysis database of over 593 cases for AKI at Red Cross War Memorial Children's Hospital (RCWMCH) over 20 years focusing on ‘Peritoneal dialysis (PD) first for our paediatric AKI program' whereby most children received PD as a first modality, despite having extracorporeal dialysis available. Types of dialysis were reviewed, as well as complications with acceptable outcomes described. Lessons learned from regional training of paediatric nephrology fellows in Africa There is a significant shortage of staff managing children with AKI in Africa and this is a review of our training program (1999 – 2021) of 38 African paediatric nephrology fellows. The emphasis is on training in paediatric AKI, including a review of hands-on training and length of training time in our unit, including subspecialty exams and research. Although a 100% return rate was noted to their home institutions, a survey was performed of our trainees on return home. This survey identified specific challenges faced and allowed for appropriateness of our training. Use of locally prepared peritoneal dialysis fluid for acute PD in children and infants in Africa including documentation of innovation of PD catheters and fluid, in the absence of conventional equipment, with good outcomes in our centre (4% peritonitis rate). Costing of our dialysis modalities included a short review in costing of dialysis modalities for acute kidney injury in our program. Conclusion: My thesis presents the development of services for children with acute kidney injury in Africa over 20 years. For me the future should be that ‘No child should die of acute kidney injury, without an attempt at peritoneal dialysis'.
dc.identifier.apacitationMc, C. M. (2025). <i>Paediatric acute kidney injury management in an African setting</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/41773en_ZA
dc.identifier.chicagocitationMc, Culloch Mignon. <i>"Paediatric acute kidney injury management in an African setting."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025. http://hdl.handle.net/11427/41773en_ZA
dc.identifier.citationMc, C.M. 2025. Paediatric acute kidney injury management in an African setting. . University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/41773en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Mc, Culloch Mignon AB - Kidney disease is a growing public health concern, affecting adults but also children who face challenges of access in low-resource settings including Africa. We studied our own paediatric dialysis results, our fellows training in the field of acute kidney injury (AKI) and reviewed innovative techniques for acute peritoneal dialysis, which also included costing of forms of acute dialysis in children. Dialysis for Paediatric AKI in Cape Town, South Africa A review of our dialysis database of over 593 cases for AKI at Red Cross War Memorial Children's Hospital (RCWMCH) over 20 years focusing on ‘Peritoneal dialysis (PD) first for our paediatric AKI program' whereby most children received PD as a first modality, despite having extracorporeal dialysis available. Types of dialysis were reviewed, as well as complications with acceptable outcomes described. Lessons learned from regional training of paediatric nephrology fellows in Africa There is a significant shortage of staff managing children with AKI in Africa and this is a review of our training program (1999 – 2021) of 38 African paediatric nephrology fellows. The emphasis is on training in paediatric AKI, including a review of hands-on training and length of training time in our unit, including subspecialty exams and research. Although a 100% return rate was noted to their home institutions, a survey was performed of our trainees on return home. This survey identified specific challenges faced and allowed for appropriateness of our training. Use of locally prepared peritoneal dialysis fluid for acute PD in children and infants in Africa including documentation of innovation of PD catheters and fluid, in the absence of conventional equipment, with good outcomes in our centre (4% peritonitis rate). Costing of our dialysis modalities included a short review in costing of dialysis modalities for acute kidney injury in our program. Conclusion: My thesis presents the development of services for children with acute kidney injury in Africa over 20 years. For me the future should be that ‘No child should die of acute kidney injury, without an attempt at peritoneal dialysis'. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Acute Kidney Injury KW - Peritoneal Dialysis Fluid LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Paediatric acute kidney injury management in an African setting TI - Paediatric acute kidney injury management in an African setting UR - http://hdl.handle.net/11427/41773 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41773
dc.identifier.vancouvercitationMc CM. Paediatric acute kidney injury management in an African setting. []. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41773en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectAcute Kidney Injury
dc.subjectPeritoneal Dialysis Fluid
dc.titlePaediatric acute kidney injury management in an African setting
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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