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How to increase adequacy of peritoneal dialysis in children?

Cornelis H Schröder1

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

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|July 29, 2005
PubMed

Insights

Optimizing peritoneal dialysis for children involves careful management of dialysis cycles, fluid volume, and solution choice. Ensuring adequate dialysis requires considering patient rest, membrane permeability, and specific solution parameters for effective treatment.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy

Background:

  • Nightly intermittent peritoneal dialysis is common for children requiring dialysis.
  • Dialysis adequacy is crucial for effective treatment outcomes in pediatric patients.

Purpose of the Study:

  • To outline key factors determining dialysis adequacy in children undergoing nightly intermittent peritoneal dialysis.
  • To provide guidelines for optimizing dialysis parameters in pediatric peritoneal dialysis.

Main Methods:

  • Assessing the impact of cycle number and duration on dialysis adequacy.
  • Evaluating the role of dialysis fluid volume and intraperitoneal pressure.
  • Considering the choice of dialysis solution, including glucose concentration and icodextrin use.

Main Results:

  • Dialysis adequacy depends on cycle parameters, fluid volume (1200 mL/m2 BSA), and intraperitoneal pressure (5-15 cm H2O).
  • Peritoneal membrane permeability, assessed via peritoneal equilibration test, influences cycle duration.
  • Lower glucose concentrations in dialysis solutions are recommended, with potential use of icodextrin for daytime dwells.

Conclusions:

  • Effective pediatric peritoneal dialysis requires tailored adjustments to dialysis parameters.
  • Optimizing dialysis solution composition and delivery methods is essential for children on dialysis.

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