A 14-year-old child was referred to us for initiation of maintenance peritoneal dialysis. He was a known case of CKD since 6 years of age and lost to follow up for last 4 years. He was found to have hypotension (BP of 70/50) and severe acidosis. The parents enquired about the best nephrologist in Vijayawada and the best dialysis centre in Andhra Pradesh and were referred to us. He was given fluid bolus, and was planned for dialysis. In view of severe acidosis, it was opted to go for hemodialysis despite presence of low BP. The risk was explained to the parents and the child was initiated on SLEDD-f. His BP recovered after one session of dialysis, he underwent total of 3 dialysis followed by which he had renal recovery and has become dialysis independent currently. This case highlights the importance of SLEDD-f, and about attempting for renal recovery even in most challenging scenarios. It was immensely gratifying to see the child walk back home with many smiles instead of needles and catheters.
Figure 1: Inserting Dialysis catheter in the Child.
Figure 2: Child undergoing SLEDD-f