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IgG and IgG subclasses deficiency in children undergoing continuous ambulatory peritoneal dialysis and its
Sema Akman1, Ayfer Gür Güven, Selma Ince
1Department of Pediatric Nephrology, Akdeniz University Medical Faculty, Antalya, Turkey. sakman@med.akdeniz.edu.tr
Insights
Children on continuous ambulatory peritoneal dialysis (CAPD) may experience immunoglobulin G (IgG) deficiency, increasing peritonitis risk. Monitoring IgG levels is crucial for managing these pediatric patients.
Area of Science:
- Pediatric Nephrology
- Immunology
- Renal Replacement Therapy
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) in children may compromise peritoneal defense.
- Low serum immunoglobulin G (IgG) or IgG subclasses are linked to peritonitis in CAPD patients.
- Malnutrition, peritoneal loss, and recurrent peritonitis can cause IgG deficiency.
Purpose of the Study:
- To investigate IgG and IgG subclass levels in children undergoing CAPD.
- To determine the relationship between IgG deficiency, malnutrition, peritonitis rates, and CAPD duration.
Main Methods:
- Serum IgG subclass levels were measured in 12 pediatric CAPD patients (aged 6-16 years) using radial immunodiffusion.
- Statistical analysis (SPSS) was employed to correlate IgG levels with malnutrition, peritonitis, and CAPD duration.
Main Results:
- Eight of 12 patients had low total IgG levels.
- Deficiencies were observed in IgG1 (8 patients), IgG2 (4), IgG3 (1), and IgG4 (3).
- Total IgG correlated positively with malnutrition, peritonitis, and CAPD duration; IgG2 with duration; IgG4 with peritonitis.
Conclusions:
- Children on CAPD are susceptible to developing IgG and IgG subclass deficiencies.
- Regular monitoring of serum IgG and its subclasses is recommended for pediatric CAPD patients.
Background:
Low levels of serum IgG or IgG subclasses may be responsible for the defective peritoneal defense and for peritonitis attacks in continuous ambulatory peritoneal dialysis (CAPD) children. Malnutrition, peritoneal loss or frequent peritonitis may lead to IgG or IgG subclasses deficiency.
Methods:
Levels of IgG subclasses were determined in 12 children undergoing CAPD treatment. Radial immunodiffusion technique was used for determination. Patients were aged from 6 to 16 years (mean age 12.3 years) and had been on CAPD for 11-26 months (mean duration 19.4 months). We evaluated whether IgG and IgG subclasses deficiency are related to malnutrition, the peritonitis rate and the duration of CAPD using the SPSS program.
Results:
Serum total IgG levels were found to be low in eight out of 12 patients. Eight patients showed low levels of IgG1, four patients IgG2, one patient IgG3 and three patients IgG4. Total IgG values were found to be positively correlated to malnutrition status, peritonitis rate and duration of CAPD. The IgG2 values were found to be related to the duration of CAPD. The IgG4 values were found to be correlated to the peritonitis rates.
Conclusions:
The IgG and IgG subclasses deficiency may develop in children while on CAPD treatment. Periodical determinations of either serum IgG or the subclasses may be useful in the follow-up of these patients.