Original Research Article International Journal of Medical Pediatrics and Oncology, April-June, 2016:2(2):46-50 46 Effect of peritoneal dialysis on malarial AKI children: a cross sectional study Nihar Ranjan Mishra 1,* , Prakash Chandra Panda 2 , Sarthak Ranjan Nayak 3 1 Senior Resident, 2 Associate Professor, Dept. of Pediatrics, Veer Surendra Sai Institute of Medical Sciences, Odisha, 3 Assistant Professor, Dept. of Biochemistry, IMS & SUM Hospital, Bhubaneswar *Corresponding Author: Email: drnihar.mishra@gmail.com Abstract Background: Peritoneal dialysis (PD) is the main stream of treatment as renal replacement therapy in pediatric patients with AKI in developing countries. Acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults, but its incidence, prevalence and clinical importance in paediatric medicine not well documented. Objectives: To find out the effect of peritoneal dialysis on outcome of malarial AKI children in a tertiary care centre. Methods: A cross-sectional study done in under 14 children suffering from severe malaria (SM). Neonates, children with associated pre-existing renal disease or having chronic kidney disease (CKD) or acute on CKD and known hypertensives were excluded. All the enrolled children were screen for AKI as per KDIGO guidelines & categorised in two three stages. PD was done as per the predefined criteria& all relevant data were analysed with computer generated software. Results: Out of 406 SM cases, AKI detected in 15% with female predominance Mortality among renal failure patients is 26.67%. PD required in 52.0% of patients & mortality rate of 25.0% in KDIGO stage I, II but 55.0% in KDIGO Stage III significance(p=0.000). There is a significant correlation between pre dialysis & post dialysis serum urea/ creatinine/ potassium/ TPC & urine output (p = 0.000). Conclusion: AKI is an under-recognized complication in young kids with SM and is related to enhanced acute/ long-term morbidity & mortality. Its early detection & intervention by peritoneal dialysis improves the same. Keywords: Severe malaria (SM), Acute Kidney Injury (AKI), Peritoneal dialysis(PD), KDIGO(Kidney Disease: Improving Global Outcome) guidelines, Chronic, Kidney Disease(CKD) Access this article online Quick Response Code: Website: www.innovativepublication.com DOI: 10.5958/2455-6793.2016.00001.8 Introduction Malaria could be a major reason of mortality and morbidity within the tropical and subtropical regions 1 with overwhelming importance within the developing world like India these days with a calculable 300-500 million cases and > 1million deaths every year. Most complications & deaths from malaria are caused by plasmodium 2 . Of the 2.5 million according cases within South East Asia, India alone contributes about 70% of the total 3,4 . Presently Odisha contributes most burden attributable to malaria to the nation 3 . Nearly 22% cases and 20% deaths due to malaria in India were accorded from Odisha. This matter is severe in southern and western districts of Odisha with a predominant tribal population 5 . AKI (Formerly ARF) usually happens in Falciparum malaria 2,6 . Generally the prevalence of acute kidney injury in falciparum malaria varies in between 1% to 60% depending upon the severity of infection 7 . In India the number reported as 13% in North East India, 17.2% in Odisha and 17.8% in Delhi. Antecedentaly AKI was rare in kids; however currently has an increasing trend in older kids 8 . Presently there is an upsurge in the overall incidence from 13% to 17.8% of malarial patients of South East Asian regions 2 . Though it is known that children admitted to hospital with SM and AKI are at increased risk of death, renal injury is rare in children with SM and is often reversible in survivors 9 . Estimates of the incidence and prevalence of AKI in children with SM are restricted with prior studies victimisation either measurements of urine output, which can be insensitive in mild to moderate acute kidney injury, or single estimates of creatinine or BUN, which may not capture the extent of AKI over time in children with severe malaria (SM) and may miss little changes in renal function that are presently known to be related with less favourable outcomes. There is increasing proof that even little changes in kidney function are related to increased morbidity, mortality and an increased risk of developing CKD 10 . The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines suggest broadening the definition of AKI 10 to comprehend acute changes in renal function & this guideline was accustomed outline AKI during this study. In developed countries, the selection of modalities for renal replacement therapy (RRT) in pediatric AKI is broad and includes PD, intermittent haemodialysis (HD), and continuous renal replacement therapy 11 . In contrast, choice for RRT in pediatric AKI in several parts of developing country is limited 11,12,13,14 . Acute PD has been the renal replacement therapy of choice for many