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Infectious and surgical complications of childhood continuous ambulatory peritoneal dialysis
J P van Asseldonk1, C H Schröder, R S Severijnen
1Department of Paediatrics, Sint Radbound University Hospital, Nijmegen, The Netherlands.
Insights
This study examined complications in pediatric continuous ambulatory peritoneal dialysis (CAPD). Young children experienced high hernia rates, while infections and obstructions presented common challenges requiring management.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a vital renal replacement therapy for pediatric patients.
- Understanding complication rates in young children undergoing CAPD is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To retrospectively analyze the incidence of infectious and surgical complications in a cohort of young children undergoing CAPD.
- To identify factors associated with specific complications like hernias, infections, and catheter-related issues.
Main Methods:
- A 10-year retrospective study was conducted.
- Data from 43 pediatric patients (mean age 4.5 years) on CAPD were analyzed.
- Incidence of infectious (peritonitis, catheter-related infections) and surgical complications (hernias, obstructions, leakage) were recorded.
Main Results:
- Infectious complication rates (peritonitis, catheter infections) were consistent with existing literature.
- A high incidence of hernias (53%) was observed, potentially linked to the young patient age.
- Obstructions were attributed to omental wrapping, peritonitis, or surgery, independent of catheter dwell time.
- Early leakage (within 5 days) allowed catheter maintenance, unlike later leakages often preceded by other complications.
Conclusions:
- Pediatric CAPD patients, especially younger ones, face unique challenges including a high risk of hernias.
- Infection and obstruction management are key considerations in pediatric CAPD.
- Timely identification and management of complications like leakage are essential for successful CAPD therapy in children.
Abstract:
A 10-year retrospective study was performed with respect to the incidence of infectious and surgical complications in a young paediatric continuous ambulatory peritoneal dialysis population of 43 children (mean age 4.5 years [range 2.5 months-15.8 years]). The incidence of infectious complications such as peritonitis and catheter-related infections correlated well with the results of other studies. A relatively high incidence of hernias (53%) was seen in our population, probably caused by the lower mean age of the children. Obstructions were caused by omental wrapping, peritonitis, or operative procedures and did not correlate with the period of catheter function. Early leakage occurred within 5 days after catheter implantation. Later leakages were preceded by another complication, such as infection or obstruction. In early leakage, in contrast to later leakage, the catheter could be maintained.