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Peritoneal dialysis in children with end-stage renal disease
Franz Schaefer1, Bradley A Warady
1Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany. franz.schaefer@med.uni-heidelberg.de
Insights
Peritoneal dialysis is the preferred treatment for children with chronic kidney disease. International registries help overcome research limitations, providing insights into complications and comorbidities in pediatric peritoneal dialysis.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Peritoneal dialysis is the primary chronic dialysis method for children due to its broad applicability and lifestyle compatibility.
- Clinical research in pediatric peritoneal dialysis faces challenges due to the low incidence of end-stage renal disease (ESRD) in this population.
Purpose of the Study:
- To review key findings from international pediatric peritoneal dialysis registries.
- To highlight variations in patient conditions, dialysis practices, and comorbidity management globally.
Main Methods:
- Systematic review of data from multiple international and long-standing pediatric peritoneal dialysis registries.
- Analysis of technique-specific complications and comorbidities associated with ESRD in children.
Main Results:
- International registries have provided valuable data despite low pediatric ESRD incidence.
- Significant global variations exist in patient profiles, peritoneal dialysis techniques, and comorbidity management.
Conclusions:
- Pediatric peritoneal dialysis registries are crucial for advancing research and improving patient outcomes.
- Addressing the observed global variations is essential for optimizing care for children undergoing peritoneal dialysis.
Abstract:
Peritoneal dialysis is the preferred chronic dialysis modality for most children owing to its almost universal applicability and superior compatibility with lifestyle over other modalities. Although technological advances and increasing clinical experience have impacted favorably on patient and technique survival, clinical research in pediatric peritoneal dialysis has been hampered by the low incidence of end-stage renal disease (ESRD) in the pediatric population. To overcome this limitation, several international registries have emerged in the past few years to complement other long-standing registries, which together have provided useful information regarding technique-specific complications and comorbidities associated with ESRD in children undergoing chronic peritoneal dialysis. In this Review, we summarize the most relevant findings from these studies, highlighting the substantial variation in patient conditions, peritoneal dialysis practices and management of comorbidities encountered in different parts of the world.
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