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CAPD in saudi arabian children: ten years experience from a single center
A A Al Salloum1, M M Al Mugeiren, S Al Rasheed
1Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Chronic ambulatory peritoneal dialysis (CAPD) is a viable renal replacement therapy for pediatric patients in geographically challenging regions. This study highlights its effectiveness and outcomes in Saudi Arabia.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Dialysis Techniques
Background:
- Chronic ambulatory peritoneal dialysis (CAPD) is a crucial treatment for end-stage renal disease (ESRD) in children.
- Understanding the efficacy and challenges of CAPD in diverse geographical settings is essential for optimizing pediatric care.
Purpose of the Study:
- To evaluate the experience and outcomes of pediatric patients undergoing chronic ambulatory peritoneal dialysis (CAPD).
- To assess the incidence of complications, treatment modalities, and long-term results of CAPD in children.
Main Methods:
- A retrospective analysis of 51 pediatric patients treated with CAPD between 1984 and 1993.
- Data collection included patient demographics, causes of ESRD, CAPD duration, peritonitis rates, catheter-related issues, and patient outcomes.
Main Results:
- Reflux nephropathy was the primary cause of ESRD (27.9%).
- The overall peritonitis incidence was high (1 episode per 4.7 patient-months), with gram-positive organisms being the most common cause.
- Catheter-related complications and infections necessitated changes in 39.5% of cases.
- Mothers performed dialysis in 90.7% of patients.
- At study end, 16.2% remained on CAPD, 37.2% received transplants, and 14.0% died.
Conclusions:
- CAPD can be a suitable renal replacement therapy for children, particularly in countries like Saudi Arabia with vast geographical areas and low population density.
- High peritonitis rates and catheter complications require careful management and monitoring.
- Successful transplantation and recovery were observed, indicating the potential for long-term positive outcomes.
Abstract:
In this paper we describe our experience with chronic ambulatory peritoneal dialysis (CAPD) in children. Between 1984 and 1993, a total of 51 patients were treated by CAPD at King Khalid University Hospital. Eight patients were excluded from the study because of incomplete data. There were 25 boys and 18 girls aged three months to 16 years; 12 patients (27.9%) were below two years, 15 patients (34.9%) were between 2-6 years, and 16 patients (37.2%) were above six years of age. Reflux nephropathy secondary to obstructive uropathy was the main cause of ESRD in the study patients (27.9%). The total period of CAPD was 579 patient-months (48.25 years). The overall incidence of peritonitis was high, one episode per 4.7 patient months; one episode per 3.2 patient months in the first five years of the study and one episode per 6.2 patient-months in the 2nd five years of the study period. The cause of peritonitis was gram positive organisms in 38.7% and gram negative organisms in 24.9%. Seventeen (39.5%) of catheters were changed because of infection or mechanical obstruction. In 90.7% of patients, the mother was the person who was performing dialysis. At the end of the study, seven patients (16.2%) were still on CAPD, 10 patients (23.3%) shifted to heraodialysls, 16 patients (37.2%) were transplanted, six patients (14.0%) died and four patients (9.3%) recovered. We conclude that CAPD may be a suitable renal replacement therapy for children in a country with a wide geographical area and low population density as Saudi Arabia.