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The choice of dialysis solutions in pediatric chronic peritoneal dialysis: guidelines by an ad hoc European committee

C H Schröder1,

  • 1Department of Pediatric Nephrology, Wilhelmina Children's University Hospital, Utrecht, The Netherlands. c.h.schroder@wkz.azu.nl

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 11, 2002
PubMed

Insights

Guidelines for pediatric peritoneal dialysis (PD) solutions recommend using the lowest effective glucose concentration and low calcium solutions. Amino acid fluids and polyglucose solutions may be considered, with bicarbonate preferred as a buffer pending further research.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Dialysis Solutions

Background:

  • Chronic peritoneal dialysis (PD) is a crucial renal replacement therapy for children.
  • Optimizing PD solutions is essential for effective treatment and patient outcomes.
  • Current guidelines for pediatric PD solutions require refinement based on evidence and expert opinion.

Framework:

  • This guideline addresses the selection of dialysis solutions for pediatric patients undergoing chronic PD.
  • It synthesizes available evidence and expert consensus from the European Paediatric Peritoneal Dialysis Working Group.
  • Key considerations include osmotic agents, mineral balance, nutritional support, and buffering agents.

Implementation:

  • Glucose is the standard osmotic agent; use the lowest effective concentration.
  • Low calcium (1.25 mmol/L) PD solutions are recommended, with parathyroid hormone monitoring.
  • Amino acid-containing fluids can be considered for malnourished children, prioritizing enteral nutrition.
  • Polyglocuse solutions are beneficial for insufficient ultrafiltration or solute removal in nocturnal intermittent PD.
  • Bicarbonate-buffered solutions are preferred, but further in vivo studies are needed.

Implications:

  • Appropriate selection of PD solutions can enhance treatment efficacy and patient well-being in pediatric chronic PD.
  • Further research is needed to establish long-term safety and efficacy of newer PD solutions in children.
  • Standardizing PD solution protocols can improve care consistency for pediatric patients with kidney disease.
Abstract

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