Continuous peritoneal dialysis in children: a single-centre experience in a developing country

Narayan Prasad1, Sanjeev Gulati, Amit Gupta

  • 1Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Insights

Continuous peritoneal dialysis (CPD) is a viable treatment for children with end-stage renal failure (ESRF) in developing nations. This study shows CPD effectively bridges patients to kidney transplantation, offering a crucial therapeutic option.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy

Background:

  • Continuous peritoneal dialysis (CPD) is the primary dialysis method for pediatric end-stage renal failure (ESRF).
  • Limited data exists on CPD in children from developing countries.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of continuous ambulatory peritoneal dialysis (CAPD) in children with ESRF in India.
  • To assess CAPD as a bridge to renal transplantation.

Main Methods:

  • Retrospective study of 30 pediatric ESRF patients (mean age 13 years) on CAPD from 1994-2004.
  • Analysis of peritonitis episodes, causative organisms, and patient outcomes including transplantation, mortality, and technique failure.

Main Results:

  • The peritonitis rate was 0.58 episodes per patient-year, with E. coli being the most common pathogen.
  • 23.3% of patients received a renal transplant, 36.6% were awaiting transplant, 26.6% died, and 6.7% experienced technique failure.
  • The mean cumulative survival time for patients on CPD was 42 months.

Conclusions:

  • Continuous peritoneal dialysis is a feasible and effective dialysis modality for children with ESRF in developing countries.
  • CAPD serves as a successful bridge to renal transplantation, improving patient survival and quality of life.

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