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Outcomes of infants <28 days old treated with peritoneal dialysis for end-stage renal disease

Michelle N Rheault1, Jurat Rajpal, Blanche Chavers

  • 1Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN, USA. rheau002@umn.edu

Pediatric Nephrology (Berlin, Germany)
|June 16, 2009
PubMed

Insights

Infants with end-stage renal disease (ESRD) needing peritoneal dialysis (PD) early in life can achieve long-term survival. Most infants in this study successfully received kidney transplants, improving their long-term prognosis.

Area of Science:

  • Pediatric Nephrology
  • Neonatology
  • Renal Replacement Therapy

Background:

  • End-stage renal disease (ESRD) in infants presents significant ethical and technical challenges.
  • Advances in medical management and transplantation offer improved survival for infants with ESRD.

Purpose of the Study:

  • To evaluate the long-term outcomes of infants with ESRD requiring chronic peritoneal dialysis (PD) before 28 days of age.
  • To assess patient survival and kidney transplant success in this vulnerable population.

Main Methods:

  • Retrospective review of infants initiating PD for ESRD before 28 days of age.
  • Data collected from 1995 to 2004 at University of Minnesota Amplatz Children's Hospital (n=23).

Main Results:

  • Overall 1- and 5-year patient survival rates were 52% and 48%, respectively.
  • Twelve children received kidney transplants at a median age of 1.12 years.
  • Five-year graft survival rate after transplantation was 83%.

Conclusions:

  • A majority of infants requiring early renal replacement therapy with PD can achieve long-term survival.
  • Successful kidney transplantation is a key factor in the long-term success for these infants.

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