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[Continuous ambulatory peritoneal dialysis: efficient treatment for children with terminal uremia]
Insights
Continuous peritoneal dialysis (CAPD) effectively treated pediatric renal failure, though hypoalbuminemia and cuff extrusion were common complications. This pediatric CAPD study highlights its role for children awaiting kidney transplants.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Context:
- Chronic renal failure in children presents significant management challenges.
- Continuous peritoneal dialysis (CAPD) is a treatment option for pediatric end-stage renal disease.
- Assessing the efficacy and complications of CAPD in a pediatric population is crucial.
Purpose:
- To evaluate the effectiveness and complication profile of Continuous Peritoneal Dialysis (CAPD) in children with renal failure.
- To analyze laboratory data and clinical outcomes during CAPD treatment in pediatric patients.
- To identify common complications associated with CAPD in children awaiting renal transplantation.
Summary:
- A review of 12 children (7 months–16 years) treated with CAPD for 3–24 months showed good metabolic control.
- Common complications included peritonitis (1 episode/8.8 months), hypoalbuminemia, and cuff extrusion.
- CAPD proved effective for pediatric renal failure, with 3 continuing CAPD, 6 receiving transplants, 1 switched to hemodialysis, and 2 deaths.
Impact:
- CAPD is a viable treatment for pediatric renal failure, particularly for children awaiting transplantation.
- Understanding complication rates like hypoalbuminemia and cuff extrusion can guide clinical management.
- This study contributes to the evidence base for pediatric dialysis strategies.
Abstract:
We have reviewed records of 12 children underwent CAPD between January 84 and May 88, ranging in age from 7 month to 16 years (mean age 8.9 +/- 4.9 years). CAPD treatment lasted from 3 to 24 months (average 10.3 months). Exchanges of dialysis fluid were performed by parents (8 cases) or children (3); mean volume was 41.7 +/- 8.7 ml/kg/exchange (range 32-58 ml/kg). During 132 patient months of treatment laboratory data showed a good metabolic control expect a tendency to hypoalbuminemia. There were 3 catheter changes. Complications were: peritonitis (15 episodes or one infection every 8.8 patient/treatment/months), hypertension (5 cases), hypervolemia (2), cuff extrusion (4), local exit site (5) and tunnel (2) infections and hernias (2). CAPD has been continued in 3 children; 6 other received renal transplantation, one was switched to hemodialysis and 2 died. This study has demonstrated that CAPD was an effective treatment for renal failure in children waiting renal transplant. Cuff extrusion and hypoalbuminemia were common complications in our children.