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Surgical outcomes analysis of pediatric peritoneal dialysis catheter function in a rural region

Matthew L Stone1, Damien J LaPar, John P Barcia

  • 1Department of Surgery, University of Virginia Health System, Charlottesville, VA 22908-0709, USA.

Journal of Pediatric Surgery
|July 31, 2013
PubMed

Insights

Peritoneal dialysis (PD) is effective for pediatric renal failure in rural areas. However, high primary catheter failure rates (24.6%) necessitate close infant surveillance.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Dialysis Management

Background:

  • Peritoneal dialysis (PD) is a critical renal replacement therapy for pediatric patients.
  • High-volume centers serving rural populations face unique challenges in PD delivery.
  • Understanding PD outcomes and complications is essential for optimizing patient care.

Purpose of the Study:

  • To evaluate the experience and outcomes of peritoneal dialysis (PD) in a high-volume pediatric center.
  • To analyze the incidence and risk factors for primary PD catheter failure.
  • To assess the safety and efficacy of PD for children with renal failure in a rural setting.

Main Methods:

  • A retrospective analysis of 134 PD catheter placements in 88 children (2 days to 20.2 years) from 2000-2010.
  • Primary outcome: incidence of PD catheter failure (replacement/revision within 60 days).
  • Evaluation of operative technique, longitudinal outcomes, and time to transplantation.

Main Results:

  • Primary PD catheter failure occurred in 24.6% of cases.
  • Infants under 6 months had a significantly higher incidence of primary catheter failure (p=0.02).
  • Common complications included peritonitis (22.7%), omental plugging (11.9%), and pericatheter drainage (9.0%).

Conclusions:

  • Peritoneal dialysis is a safe and effective renal replacement therapy for pediatric centers in rural areas.
  • High primary catheter failure rates (24.6%) require attention, particularly in infants.
  • Surgical technique did not impact failure rates; infants <6 months need intensive monitoring.
Abstract

Keywords:
DialysisPeritoneal dialysisRenal failureRenal transplantation

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