Continuous peritoneal dialysis in children: a single-centre experience in a developing country

Abstract

Continuous peritoneal dialysis (CPD) is the most commonly used modality of dialysis in children. Continuous ambulatory peritoneal dialysis (CAPD) has been an established form of therapy in adult patients with end-stage renal failure in India for more than a decade. There is a paucity of published experience of CPD in children from developing countries. We retrospectively studied children with end-stage renal failure (ESRD) that had been on CAPD over the past 10 years. Thirty patients with ESRD, mean age 13+/-8 years (range 5-21 years), male 18, were started on CAPD from 1994 to October 2004. The mean break-in period was 12+/-3 days. Of these 30 patients, 15 had a total of 21 episodes of peritonitis. The peritonitis rate was 0.58 episodes per patient year. E. coli was the commonest organism causing peritonitis. On outcome analysis, 7/30 (23.3%) patients received a renal transplant, while 11/30 (36.6%) continued on CAPD, awaiting a kidney transplant. Of the rest, eight (26.6%) patients died, two (6.7%) suffered technique failure and were changed to haemodialysis, and two (6.7%) were lost to follow-up after 2 months. The mean cumulative survival time of patient on CPD was 42 months. We conclude that CPD is a viable option for dialysis in ESRD children in a developing country and is a successful bridge between ESRD and renal transplantation.

Outcome and Risk Factors for Mortality in Pediatric Peritoneal Dialysis

“…The peritonitis rate in our program was 1 episode per 57.79 patient-months. The low incidence of peritonitis compared to the literature (8,17) in our patients was probably due to the intense training program at initiation of dialysis.…”

Fatores de risco para peritonites e internações

“…4,10,12,13,14,15 Other dialysis complications, such as infections, especially infections of the peritoneal catheter exit site and tunnel, have been reported by six (20%) caregivers, being usually associated with poor hygiene, manipulation by patients and/or colonization by bacteria of their own skin, predisposing to peritonitis.…”

An Initial Experience of Continuous Peritoneal Dialysis in Children in the Armed Forces

“…CPD is a common modality of managing adult patients with ESRD [4]. CPD is preferred over haemodialysis (HD) in children to avoid the problems of vascular access, anticoagulation and haemodynamic imbalance [5].…”