Related Experiment Videos
Peritonitis in children undergoing chronic peritoneal dialysis (CPD): data from the Italian Registry of Pediatric CPD
E Verrina1, A Edefonti, S Bassi
1Nephrology Department, G. Gaslini Institute, Genova, Italy.
Insights
This study tracked 119 pediatric patients undergoing peritoneal dialysis (PD) from 1986-1990. Peritonitis incidence decreased over time, with no significant difference between continuous ambulatory (CAPD) and continuous cycler-assisted (CCPD) methods, though infections remained a concern.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Infectious Diseases
Background:
- Peritoneal dialysis (PD) is a treatment for pediatric end-stage renal disease.
- Continuous ambulatory peritoneal dialysis (CAPD) and continuous cycler-assisted peritoneal dialysis (CCPD) are common PD modalities.
- Understanding complication rates, particularly peritonitis, is crucial for optimizing pediatric PD therapy.
Purpose of the Study:
- To analyze the trends and outcomes of pediatric peritoneal dialysis in Italy.
- To evaluate the incidence and characteristics of peritonitis in pediatric PD patients.
- To compare peritonitis rates between CAPD and CCPD in this cohort.
Main Methods:
- Retrospective analysis of 119 pediatric patients enrolled in the Italian Registry of Pediatric PD (1986-1990).
- Data collection on dialysis modality (CAPD vs. CCPD), peritonitis incidence, causative organisms, and other complications.
- Comparison of peritonitis rates between CAPD and CCPD during the 1989-1990 period.
Main Results:
- Peritonitis incidence decreased from 1:10.9 patient-months in 1986 to 1:19.8 in 1988, then rose to 1:16.2 in 1990.
- No significant difference in peritonitis incidence was observed between CAPD and CCPD (1989-1990).
- Gram-positive bacteria (Staphylococcus aureus, S. epidermidis) were the most common pathogens; exit site infections were the predominant complication (82%). Hospitalization for peritonitis was high (61%).
Conclusions:
- Pediatric peritoneal dialysis in Italy showed a decreasing trend in peritonitis incidence during 1986-1990.
- Both CAPD and CCPD demonstrated similar peritonitis risks.
- Despite improvements, peritonitis and exit site infections remain significant challenges in pediatric PD, requiring ongoing management strategies.
Abstract:
During the period 1986-1990, 119 patients were enrolled in the Italian Registry of Pediatric CPD. CAPD was largely predominant in the first 3 years, while CCPD accounted for 48% of dialysis months in the period 1989-1990. The connect-disconnect system was a Y set for all patients during the whole observation period. The incidence of peritonitis decreased from 1 episode: 10.9 patient-months in 1986 to 1:19.8 in 1988, and then passed to 1:16.2 in 1990. A comparison of the incidence of peritonitis between CAPD and CCPD, referring to the 1989-1990 period, showed no significant difference. The percentage of positive peritoneal fluid cultures changed from 48% in 1986 to 73% in 1990. Gram-positive bacteria, primarily Staphylococcus aureus and Staphylococcus epidermidis, accounted for most of the isolated organisms. Candida albicans was cultured in 3 cases both in 1986 and 1987. Exit site infection was the predominant (82%) complication, followed by leakage and catheter cuff extrusion. The hospitalization rate for peritonitis resulted persistently high (61% of episodes) and the mean duration was 12.7 days. Of the 8 patients who were switched to hemodialysis, 4 had recurrent peritonitis and 1 Candida albicans peritonitis.