The Demographics of Dialysis in Children

Fadrowski, Jeffrey J.; Alexander, Steven R.; Warady, Bradley A.

doi:10.1007/978-1-4614-0721-8_3

Cited by 8 publications

(2 citation statements)

References 22 publications

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“…Peritoneal dialysis (PD) is the dialysis modality used by 44% of children receiving chronic dialysis in the United States (1) and the primary modality used to provide dialysis to children around the globe (2)(3)(4). Peritonitis remains the most significant complication among patients on PD (5), which can result in substantial morbidity and permanent technique failure (3).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for and Outcomes of Catheter-Associated Peritonitis in Children: The SCOPE Collaborative

Sethna

Bryant

Munshi

et al. 2016

CJASN

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Background and objectives The Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative is a quality improvement initiative that aims to reduce peritoneal dialysis-associated infections in pediatric patients on chronic peritoneal dialysis. Our objectives were to determine whether provider compliance with peritoneal dialysis catheter care bundles was associated with lower risk for infection at the individual patient level and describe the epidemiology, risk factors, and outcomes for peritonitis in the Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative.Design, setting, participants, & measurements We collected peritoneal dialysis characteristics, causative organisms, compliance with care bundles, and outcomes in children with peritonitis between October of 2011 and September of 2014. Chi-squared tests, t tests, and generalized linear mixed models were used to assess risk factors for peritonitis.Results Of 734 children enrolled (54% boys; median age =9 years old; interquartile range, 1-15) from 29 centers, 391 peritonitis episodes occurred among 245 individuals over 10,130 catheter-months. The aggregate annualized peritonitis rate was 0.46 episodes per patient-year. Rates were highest among children #2 years old (0.62 episodes per patient-year). Gram-positive peritonitis predominated (37.8%) followed by culture-negative (24.7%), gramnegative (19.5%), and polymicrobial (10.3%) infections; fungal only peritonitis accounted for 7.7% of episodes. Compliance with the follow-up bundle was associated with a lower rate of peritonitis (rate ratio, 0.49; 95% confidence interval, 0.30 to 0.80) in the multivariable model. Upward orientation of the catheter exit site (rate ratio, 4.2; 95% confidence interval, 1.49 to 11.89) and touch contamination (rate ratio, 2.22; 95% confidence interval, 1.44 to 3.34) were also associated with a higher risk of peritonitis. Infection outcomes included resolution with antimicrobial treatment alone in 76.6%, permanent catheter removal in 12.2%, and catheter removal with return to peritoneal dialysis in 6% of episodes.Conclusions Lower compliance with standardized practices for follow-up peritoneal dialysis catheter care in the Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative was associated with higher risk of peritonitis. Quality improvement and prevention strategies have the potential to reduce peritoneal dialysisassociated peritonitis.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for and Outcomes of Catheter-Associated Peritonitis in Children: The SCOPE Collaborative

Sethna

Bryant

Munshi

et al. 2016

CJASN

Self Cite

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“…In the past few decades, peritoneal dialysis (PD) started to get more acceptance as the first paediatric dialysis modality [1][2][3][4][5][6], and now, it is the most common modality of dialysis with endstage renal disease (ESRD) in many countries [7][8][9]. Before 1982, fewer than 100 paediatric patients had been treated with continuous ambulatory peritoneal dialysis (CAPD), whereas continuous cycler peritoneal dialysis for children was virtually unknown [10].…”

Section: Introductionmentioning

confidence: 99%

Chronic peritoneal dialysis in children: a single-centre experience in Jordan

Frehat¹,

Alsalaita²,

Al-bderat³

et al. 2020

Sudan J Paed

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The aim of the present study is to share the experience of chronic peritoneal dialysis (PD) at King Hussein Medical Center, Amman, Jordan, and to highlight the complications of this procedure. This is a retrospective chart review study for all the children from day 1 of life to 14 years, who underwent chronic PD for end-stage renal disease (ESRD) during the period of 10 years extending from 2009 to 2019. The following data were collected: mode of dialysis, type of peritoneal dialysis, age of starting peritoneal dialysis, gender, aetiology of ESRD, duration on PD, complications and outcome. A total number of 269 children were included: 229 patients received haemodialysis and 40 children (22 boys and 18 girls) received PD. Of those, two children were on automated PD and 38 children were on continuous ambulatory peritoneal dialysis. The mean age at the start of PD was 62 ± 38 months. The mean duration of PD was 43 months. The mean catheter duration was 34 months. Six patients were shifted to haemodialysis permanently and four patients received a kidney transplant. Eleven patients died. The most common complications were peritonitis (52.5%), exit-site infection (30%) and malfunctioning catheter (12.5%). The rate of peritonitis was one episode per 22 patient-months. Peritoneal dialysis is a promising mode of dialysis for children in Jordan. Peritonitis is the most common complication associated with PD. Kidney transplantation is the best modality of renal replacement therapy in terms of longterm survival and quality of life and should be encouraged on national level.

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Chronic PD in Children: Prescription, Management, and Complications

Neu

Schaefer

2016

Pediatric Kidney Disease

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The Demographics of Dialysis in Children

Cited by 8 publications

References 22 publications

Risk Factors for and Outcomes of Catheter-Associated Peritonitis in Children: The SCOPE Collaborative

Risk Factors for and Outcomes of Catheter-Associated Peritonitis in Children: The SCOPE Collaborative

Chronic peritoneal dialysis in children: a single-centre experience in Jordan

Chronic PD in Children: Prescription, Management, and Complications

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