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Experience with continuous cycling peritoneal dialysis during the first year of life
I B Salusky1, T von Lilien, M Anchondo
1Department of Pediatrics, UCLA School of Medicine 90024.
Insights
Continuous cycling peritoneal dialysis (CCPD) is a viable treatment for infants awaiting kidney transplants, showing minimal complications. This study details the clinical outcomes in eight infants undergoing CCPD.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Infant Health
Background:
- Infants with end-stage renal disease require renal replacement therapy.
- Continuous cycling peritoneal dialysis (CCPD) is a potential treatment option for infants.
- Limited data exists on the long-term outcomes of CCPD in infants.
Purpose of the Study:
- To describe the clinical experience and outcomes of infants treated with CCPD.
- To evaluate the efficacy and safety of CCPD in infants awaiting renal transplantation.
- To assess growth parameters and biochemical markers during CCPD therapy.
Main Methods:
- Retrospective analysis of clinical data from eight infants treated with CCPD.
- Serial monitoring of biochemical markers (BUN, creatinine, albumin, calcium, phosphorus, alkaline phosphatase).
- Assessment of anthropometric measurements including height, weight, and head circumference (SDS).
- Documentation of complications such as peritonitis and hernias.
Main Results:
- No significant changes in biochemical markers were observed during CCPD treatment.
- A statistically significant decrease in height standard deviation scores (SDS) was noted (P < 0.001).
- Body weight and head circumference SDS showed a slight decline but remained stable.
- Low incidence of peritonitis (1 episode per 11.6 patient-months) and nine hernias in six patients.
Conclusions:
- CCPD is an acceptable and safe dialysis modality for infants awaiting renal transplantation.
- Minimal morbidity associated with CCPD in this infant cohort.
- Growth parameters require careful monitoring during CCPD therapy in infants.
Abstract:
The clinical experience in eight infants aged 5.8 +/- 2.3 (SD) months at the initiation of continuous cycling peritoneal dialysis (CCPD) is described. BUN, creatinine, albumin, calcium, phosphorus and alkaline phosphatase measurements were performed serially and no changes were seen throughout the follow-up period. Mean total energy and protein intake were 94 +/- 8% and 79 +/- 9% of the recommended. The initial and final standard deviation scores (SDS) for height were -1.42 +/- 1.32 and -2.47 +/- 1.36 (P less than 0.001), respectively. The SDS for body weight and head circumference were -1.67 +/- 0.71 and -1.67 +/- 1.04, respectively, at the beginning of the study and -1.83 +/- 0.98 and -1.88 +/- 1.52, respectively, at the end of the period of observation. The incidence of peritonitis was one episode every 11.6 patient months; six patients developed nine hernias. The present study demonstrates that CCPD is an acceptable dialytic modality, with minimal morbidity, for the management of infants awaiting renal transplantation.