Comparison of CAPD and CCPD in Children and their Limitations
1Division of Nephrology, The Hospital for Sick Children, University of Toronto 555 University Avenue, Toronto, Ontario, Canada.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) are common dialysis methods for children. While CCPD has lower family strain and infection risk, CAPD may offer better biochemical control.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) was initially preferred for pediatric dialysis.
- Automated systems have led to increased use of continuous cycling peritoneal dialysis (CCPD).
Purpose of the Study:
- To compare the efficacy and outcomes of CAPD versus CCPD in pediatric patients.
- To evaluate differences in biochemical control, growth, nutrition, infection rates, and hernias/leaks between CAPD and CCPD.
Main Methods:
- Comparative analysis of pediatric patients undergoing CAPD and CCPD.
- Assessment of biochemical parameters, nutritional status, growth, and complication rates.
Main Results:
- Growth and nutrition were similar in both CAPD and CCPD groups.
- CAPD showed potentially better biochemical control.
- CCPD demonstrated advantages in reduced infection rates, hernias, and leaks due to fewer disconnections.
- CCPD involves higher initial costs but less family burden.
- Some patients prefer CAPD for lifestyle flexibility.
Conclusions:
- Both CAPD and CCPD are viable pediatric dialysis options with distinct advantages.
- CCPD may be favored for its lower complication rates and family strain, despite higher initial costs.
- CAPD remains a preferred option for some due to lifestyle flexibility and potentially better biochemical control.
Abstract:
Soon after its introduction, continuous ambulatory peritoneal dialysis (CAPD) became the choice mode of dialysis treatment for small children. With the advent of automated machines, continuous cycling peritoneal dialysis (CCPD) is now finding more favor in many centers. Initial cost of CCPD is higher due to the need for automated machines, but puts much less strain on the family. However, there is evidence that biochemical control is better with CAPD. Growth and nutrition in both groups are found to be similar. CCPD may have advantages over CAPD with regard to infection, since the former has fewer disconnections. The same is also true with regard to hernias and leaks. Some patients still prefer CAPD, since it allows more freedom in life style compared to CCPD.
