Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry

Amstel, Sophie Ploos van; Noordzij, Marlies; Borzych-Dużałka, Dagmara; Chesnaye, Nicholas; Xu, Hong; Rees, Lesley; Ha, Il Soo; Antonio, Zenaida L.; Hooman, Nakysa; Wong, William; Vondrák, Karel; Yap, Yok Chin; Patel, Hiren P.; Szczepańska, Maria; Testa, Sara; Galanti, Monica; Kari, Jameela A.; Samaille, Charlotte; Bakkaloğlu, Sevcan A.; Lai, Wai Ming; Rojas, Luisa Fernanda Quiroga; Diaz, Mabel Sandoval; Basu, Biswanath; Neu, Alicia M.; Warady, Bradley A.; Jager, Kitty J.; Schaefer, Franz

doi:10.1053/j.ajkd.2020.11.031

Cited by 18 publications

(7 citation statements)

References 26 publications

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“…Apart from age, survival on PD also varies geographically. In the International Pediatric Peritoneal Dialysis Network Registry (2,956 children, mean age 7.6 years), the 3-year probability of death varied between 2% (North America) and 9% (Eastern Europe) 215 . Mortality was higher in LICs, and about half of the variance was explained by country income category 215 .…”

Section: Pd Outcomes In Vulnerable Populationsmentioning

confidence: 99%

“…In the International Pediatric Peritoneal Dialysis Network Registry (2,956 children, mean age 7.6 years), the 3-year probability of death varied between 2% (North America) and 9% (Eastern Europe) 215 . Mortality was higher in LICs, and about half of the variance was explained by country income category 215 . In a report from India, the 3-year survival amongst 66 children started on PD was only 30%, with peritonitis being the main cause of death 216 .…”

Section: Pd Outcomes In Vulnerable Populationsmentioning

confidence: 99%

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Epidemiology of peritoneal dialysis outcomes

et al. 2022

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Peritoneal dialysis (PD) is an important home-based treatment for kidney failure and accounts for 11% of all dialysis and 9% of all kidney replacement therapy globally. Although PD is available in 81% of countries, this provision ranges from 96% in high-income countries to 32% in low-income countries. Compared with haemodialysis, PD has numerous potential advantages, including a simpler technique, greater feasibility of use in remote communities, generally lower cost, lesser need for trained staff, fewer management challenges during natural disasters, possibly better survival in the first few years, greater ability to travel, fewer dietary restrictions, better preservation of residual kidney function, greater treatment satisfaction, better quality of life, better outcomes following subsequent kidney transplantation, delayed need for vascular access (especially in small children), reduced need for erythropoiesis-stimulating agents, and lower risk of blood-borne virus infections and of SARS-CoV-2 infection. PD outcomes have been improving over time but with great variability, driven by individual and system-level inequities and by centre effects; this variation is exacerbated by a lack of standardized outcome definitions. Potential strategies for outcome improvement include enhanced standardization, monitoring and reporting of PD outcomes, and the implementation of continuous quality improvement programmes and of PD-specific interventions, such as incremental PD, the use of biocompatible PD solutions and remote PD monitoring.

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Section: Pd Outcomes In Vulnerable Populationsmentioning

confidence: 99%

Section: Pd Outcomes In Vulnerable Populationsmentioning

confidence: 99%

Epidemiology of peritoneal dialysis outcomes

et al. 2022

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“…The most serious complication of CPD is peritonitis, which increases the morbidity as well as mortality of children on CPD. [ 29 ] In our cohort, peritonitis was the most common presentation. The median time to the onset of peritonitis was 52 days after PD catheter insertion.…”

Section: Discussionmentioning

confidence: 91%

Chronic peritoneal dialysis in children with chronic kidney disease

Sharawat

Tiewsoh

Soni

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: Chronic peritoneal dialysis (CPD) is an important modality of renal replacement therapy (RRT) in children of all ages with end-stage renal disease (ESRD). We retrospectively assessed the clinical profile of children with chronic kidney disease (CKD) initiated on CPD at a tertiary care centre in Northern India. Materials and Methods: Retrospective data of 13 children with CKD and initiated on CPD between 2016 and 2019 were retrieved and analysed. The demographic and clinical profile, aetiology of CKD, method of catheter insertion, mode of dialysis, complications, and catheter survival rate were analysed. Results: The median age at the onset of the symptoms was 81 months interquartile range (IQR 11–90) and the median age at the diagnosis was 81 months (IQR 36–103). The median age at the initiation of CPD was 92.97 months (IQR 74.43–108.79). The median serum creatinine at the initiation of CPD was 6.3 mg/dL (IQR 4.25–8.4). During a total study period of 84 CPD months, we observed 16 catheter-related complications and a complication rate of 1 per 5.25 CPD months. The overall peritonitis rate was 1 episode per 13.66 patient-months (0.87 episodes per patient-year). The catheter displacement/migration was seen in 23% of the cases. The median duration of follow-up was 175 days (IQR 85–249) with the longest follow-up duration of 502 days. Conclusion: CPD is the modality of choice for smaller children with ESRD as venous access is difficult to achieve in smaller children. Complications especially related to infections are a major concern in addition to poor growth associated with ESRD.

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“…Family dynamics changes, children miss school, and issues with vascular accesses compound to build hurdles to patient progression and draw them closer to a kidney transplant 14 . Death might be the outcome in places where PD or HD are not available and for newborns and children who live in cities where HD is the only option 15 .…”

Section: Discussionmentioning

confidence: 99%

Pediatric peritoneal dialysis in Brazil: a discussion about sustainability. A document by the Brazilian Society of Nephrology, the Brazilian Society of Pediatrics, the Brazilian Association of Organ Transplantation, and the Brazilian Association of Dialysis and Transplant Centers

et al. 2022

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Introdução: A diálise peritoneal (DP) é importante para a pediatria. Este estudo mostrou dados de centros brasileiros que utilizam DP pediátrica. Método: Estudo transversal, observacional, descritivo com questionário eletrônico. Incluiu-se pacientes de 0-18 anos em DP cadastrados nos bancos de dados dos diversos centros. Questionário preenchido anonimamente, sem dados de identificação. Foi adotada metodologia quantitativa. Resultados: 212 pacientes estão em DP no Brasil (agosto, 2021). 80% têm menos de 12 anos de idade. A maioria realiza DP automatizada e 74% são dependentes do Sistema Único de Saúde. Em 25% dos centros faltou material de DP e em 51% os pacientes pediátricos foram convertidos de DP para HD. Conclusão: A maioria dos pacientes tinha menos de 12 anos e era dependente do SUS. A escassez de insumos aconteceu em 25% dos centros. Esses dados apontam para o problema da sustentabilidade de DP, única alternativa de TRS em crianças muito pequenas.

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Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry

Cited by 18 publications

References 26 publications

Epidemiology of peritoneal dialysis outcomes

Epidemiology of peritoneal dialysis outcomes

Chronic peritoneal dialysis in children with chronic kidney disease

Pediatric peritoneal dialysis in Brazil: a discussion about sustainability. A document by the Brazilian Society of Nephrology, the Brazilian Society of Pediatrics, the Brazilian Association of Organ Transplantation, and the Brazilian Association of Dialysis and Transplant Centers

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