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Continuous peritoneal dialysis in children
Insights
Continuous peritoneal dialysis (CPD) effectively treated acute renal failure in children, with 73% recovering kidney function. While complications like peritonitis occurred, CPD is a viable option for pediatric acute renal failure management.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) in children presents significant management challenges.
- Continuous peritoneal dialysis (CPD) is a potential treatment modality for pediatric ARF.
Purpose of the Study:
- To evaluate the efficacy and safety of CPD in treating pediatric patients with acute renal failure.
- To identify common causes of ARF in children and assess treatment outcomes.
Main Methods:
- Retrospective analysis of 48 children treated with CPD for ARF between June 1985 and December 1991.
- Data collection included patient demographics, diagnoses, treatment complications, and outcomes.
Main Results:
- Kidney function recovered in 73% of patients; 27% died from underlying conditions.
- Hemolytic uremic syndrome was the most frequent diagnosis (n=22).
- Hyperkalemia and uremia were manageable, but ultrafiltration was challenging with low cardiac output. Peritonitis occurred in 11 patients, and catheter revisions were needed in 8.
Conclusions:
- CPD is an effective treatment for acute renal failure across all pediatric age groups.
- While complications exist, they are considered acceptable given the severity of the underlying conditions.
Abstract:
During the period from June 1985 to December 1991, 48 children were treated with continuous peritoneal dialysis (CPD) in our centre because of acute renal failure. The median age was 1.8 years (range 0.01-17.1). The most common diagnoses were: hemolytic uremic syndrome (n = 22), anuria after cardiac surgery (n = 7), and septicemia with multiorgan failure (n = 7). Kidney function recovered in 35 (73%); 13 (27%) died of their original disease. One further patient with HUS recovered from dialysis but died of cerebral complications shortly afterwards. One patient remained anuric and requires renal replacement therapy. Hyperkalemia, when present initially, and uremia could be controlled adequately in all cases. However, ultrafiltration posed problems when cardiac output was low. Peritonitis occurred in 11 patients; in 8 children the Tenckhoff catheter had to be revised because of leakage (5), flow problems (2), or bowel perforation (1). CPD proved to be an excellent method to treat acute renal failure in children of all age groups. The rate of complications was acceptable.