Background: The peritonitis rate among children treated with peritoneal dialysis (PD) has not been widely reported in Saudi Arabia. The study aim was to estimate the peritonitis rate per patient-year and investigate the factors associated with higher peritonitis rates in a sample of PD children at King Abdullah Specialist Children’s Hospital-Riyadh (KASCH-R), Saudi Arabia. Methods: This retrospective cohort study included 27 PD children treated between September 2007 and December 2017 at KASCH-R. We recorded the children’s demographic and clinical data, and the frequency of peritonitis. Results: The 27 PD children reviewed (63% girls; mean age = 7.32 years old; range, 1–14 years), resulted in 86 peritonitis diagnoses in which the overall recurrence rate (in at least one episode) was 58/86 (67.4%) with a 95% confidence interval (CI), 56.5 to 77.2%. The rate of peritonitis episodes per patient-year was 0.76 (1 episode per 1.31 patient-year). The generalized Poisson model identified older children (age > 10 years) (adjusted rate ratios [aRR] = 7.273, 95% CI: 1.562–33.860), congenital nephrosis (aRR = 4.677, 95% CI: 1.443–15.155), height below 3rd percentile (aRR = 4.689, 95% CI: 1.874–11.735), weight below 3rd percentile (aRR = 5.388, 95% CI: 1.678–17.302), low albumin level (aRR = 4.041, 95% CI: 2.053–7.956), two-week duration of antibiotic therapy (aRR = 2.947, 95% CI: 1.163–7.468), which were independently associated with a high peritonitis rate. Conclusions: This study showed a high peritonitis rate in our center. Older children, congenital nephrosis, height and weight below the 3rd percentile, low albumin level, and long duration of antibiotic therapy were associated with a higher rate of peritonitis. An optimal peritonitis prevention strategy or best-practice guideline is needed to reduce and prevent peritonitis occurrence in our center.

Child abuse is a challenging problem that any healthcare worker might encounter. It can lead to multiple physical and psychological effects on the child. We report a case of an eight-year-old boy who presented to the emergency department with history of decreased level of consciousness and change in urine color. On examination, he was found to be jaundiced, pale, and hypertensive (160/90 mmHg) with multiple skin abrasions all over the body, suggestive of physical abuse. Laboratory investigations were consistent with acute kidney injury and significant muscle damage. The patient was admitted to intensive care unit (ICU) as a case of acute renal failure secondary to rhabdomyolysis, and subsequently required temporary hemodialysis during his stay in the ICU. The child protective team was involved in the case throughout his hospital admission. Rhabdomyolysis with acute kidney injury secondary to child abuse is an unusual presentation in children, and reporting such cases may lead to early diagnosis and initiation of prompt interventions.