Complications of CAPD in children: six years experience in Caracas, Venezuela

Forty-three ESRD children received treatment with CAPD from November 1984 through July 1990. Mean patient age was 10 years (range 2-17 years) and total observation period (consolidated for the whole group) was 683 months. Double cuff Tenckhoff catheters were used as access. The most common complication was peritonitis with an overall rate of one episode per 5.6 patient/months. Important correlation was found between incidence of peritonitis and socioeconomic status assessed by Graffar Index (G.I.). Patients with lowest socioeconomic status (GI of IV and V) had one episode of peritonitis per 2.9 patient/months. Patients with GI of III had one episode per 5.2 patient/months and patients with the best socioeconomic status (GI of I and II) had only one episode per 11.6 patient/months. Other complications were the following: Infections: 18 exit site infection, 5 exit site granuloma and 5 tunnel abscess. Catheter malfunction: 17 obstructions, 5 migrations and 2 ruptures. Others: 3 peritoneal hemorrhages, 1 intestinal perforation, 3 eventrations, 4 inguinal hernias and 1 right pleural effusion. In this last patient, pleurodesis was unsuccessfully attempted with homologous blood. We conclude that patients with very low socioeconomic status are poor candidates for CAPD and should be considered preferably for hemodialysis.