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Acute kidney injury (AKI) remains an under-appreciated problem worldwide. But in emerging countries, the avoidable loss of life is all the more striking because children and young adults are frequently affected.

Mignon McCulloch, who headed a training session aimed at teams of doctors and nurses at the World Congress of Nephrology in Cape Town, South Africa, explains that in many regions where AKI is not prevented, identified or treated early, acute peritoneal dialysis (PD) is a life-saving therapy.

Needing no power other than gravity, its simplicity means it is afford- able and can be applied almost anywhere. Most importantly, staff does not need sophisticated training to become competent in insert- ing PD catheters or manually run PD circuits.

“For the WCN session, the approach was to train the staff who deliver the dialysis, and share our experience in sub-Saharan Africa,” explains McCulloch. While identifying a physician with the passion and commitment to lead the program, it is important to train a team who will deliver long-term sustainability.

McCulloch states that competence counts more than professional status. Training in PD catheter insertion in adults, infants, and children, should be offered to surgeons, physicians, clinical officers and nurses according to local circumstances.

It is also imperative to gain commitment from hospital and regional administrators to ensure supplies are ordered, delivered and stored in suitable environments within the hospital or community. In poor resource areas, we teach the value of improvisation while using alternatives to conventional equipment and fluid.

Finally, the Saving Young Lives (SYL) team insists on teaching the value of prescribing and monitoring PD fluid regimens and managing technical complications such as peritonitis, and blocked or dislodged catheters. Training is also given with alternatives to conventional fluids and catheters where life-saving improvisation is required in the absence of conventional equipment and supplies.

Since 2011, ISN has worked with the International Pediatric Nephrology Association (IPNA), the International Society for Peritoneal Dialysis (ISPD) and Sustainable Kidney Care Foundation (SKCF) to initiate Saving Young Lives (SYL), a program to develop and sustain hospital centers, which can provide acute PD, focused initially on sub- Saharan Africa and South East Asia.

SYL is now supporting a dozen centers in Africa including Benin, Ethiopia, Ghana, Cameroon, the Democratic Republic of Congo, Ivory Coast, Malawi, Tanzania, Uganda; as well as one in Cambodia. A recent training workshop successfully took place in Sudan.

For more about Saving Young Lives, click here.