Related Experiment Video

Updated: Nov 23, 2025

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
06:27

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

Published on: July 20, 2022

2.9K

Acute peritoneal dialysis, complications and outcomes in 389 children with STEC-HUS: a multicenter experience

Paula A Coccia1, Flavia B Ramírez2, Angela D C Suárez3

  • 1Division of Pediatric Nephrology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. paula.coccia@hospitalitaliano.org.ar.

Pediatric Nephrology (Berlin, Germany)
|January 4, 2021
PubMed

Insights

Acute peritoneal dialysis (PD) is a safe and effective treatment for children with Shiga toxin-producing Escherichia coli-induced hemolytic uremic syndrome (STEC-HUS) and acute kidney injury (AKI). Antibiotic prophylaxis before PD catheter insertion can reduce peritonitis risk.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Shiga toxin-producing Escherichia coli-induced hemolytic uremic syndrome (STEC-HUS) frequently causes acute kidney injury (AKI) in children, often requiring kidney replacement therapy (KRT).
  • Peritoneal dialysis (PD) is a common KRT method, but its complications, particularly peritonitis, need careful evaluation in this pediatric population.

Purpose of the Study:

  • To analyze procedure-related complications and clinical outcomes in children with AKI secondary to STEC-HUS treated with acute PD.
  • To identify risk factors for complications such as peritonitis during PD in pediatric STEC-HUS cases.

Main Methods:

  • A multicenter retrospective study involving 389 children with STEC-HUS requiring PD across 37 Argentinian centers between January 2015 and February 2019.
  • Review of medical records to assess PD procedure complications, including catheter malfunction, peritonitis, fluid leaks, bleeding, and hyperglycemia.
  • Multivariate analysis to determine factors associated with peritonitis and PD discontinuation.

Main Results:

  • The most frequent complications were catheter malfunction (24%), peritonitis (19%), and fluid leaks (11.5%).
  • Antibiotic prophylaxis was linked to a reduced risk of peritonitis (HR 0.49), while open-surgery catheter insertion increased the risk (HR 2.8).
  • PD discontinuation occurred in 3.8% of patients; mortality was 2.8% due to extrarenal complications, not PD-related issues.

Conclusions:

  • Acute PD is a safe and effective modality for managing AKI in children with STEC-HUS.
  • Prophylactic antibiotics before PD catheter insertion are recommended to minimize peritonitis incidence.
  • Careful monitoring for complications is essential, but PD is generally well-tolerated in this patient group.
Abstract

Keywords:
Acute kidney injuryAcute peritoneal dialysisChildrenHemolytic uremic syndromeKidney replacement therapyPeritonitisShiga toxin–producing Escherichia coli

More Related Videos

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion06:23

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion

Published on: May 23, 2025

1.3K
Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

15.7K

Related Concept Videos

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
230
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
316
Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
347
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
141
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
131
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
122