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[Peritoneal dialysis in children after cardiac surgery]
L Kovacikova1, P Kunovsky, M Lakomy
1Cardiac Intensive Care Unit DFNsP, Limbova 1, SK-833 40 Bratislava 37, Slovakia. lubakov@ba.psg.sk
Bratislavske Lekarske Listy
|January 12, 2001
Summary
Peritoneal dialysis (PD) effectively treated acute renal failure in pediatric cardiac surgery patients, with most survivors recovering renal function. Long-term follow-up revealed minimal residual renal dysfunction in survivors.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Surgery
- Renal Replacement Therapy
Context:
- Acute renal failure (ARF) is a significant complication in pediatric cardiac surgery.
- Peritoneal dialysis (PD) is a potential treatment modality for ARF in this population.
Purpose:
- To analyze the experience and outcomes of using peritoneal dialysis (PD) in children with acute renal failure following cardiac surgery.
Summary:
- 38 children underwent PD for ARF post-cardiac surgery, with indications including oliguria, anuria, hyperkalemia, and fluid overload.
- PD was initiated post-operatively and lasted an average of 53.7 hours. No peritoneal infections occurred, though hyperglycemia and catheter issues were noted.
- Mortality was high (57.9%) due to low cardiac output, but 16 survivors regained renal function, with most showing no significant long-term dysfunction.
Impact:
- Peritoneal dialysis is a viable option for managing acute renal failure in pediatric cardiac surgery patients.
- While PD is effective, patient outcomes are heavily influenced by the severity of cardiac dysfunction.
- Long-term renal function is generally preserved in survivors, though monitoring for subtle tubular dysfunction is warranted.