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[Continuous ambulatory peritoneal dialysis (CAPD) in children and adolescents]
Insights
Continuous ambulatory peritoneal dialysis (CAPD) offers a simpler, less painful home dialysis option for children with end-stage renal disease. Improved training and standardized care significantly reduced complications like peritonitis.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Context:
- End-stage renal disease (ESRD) management in pediatric patients.
- Continuous ambulatory peritoneal dialysis (CAPD) as an alternative to hemodialysis.
Purpose:
- To evaluate the efficacy and safety of CAPD in children and adolescents.
- To compare CAPD outcomes with hemodialysis.
Summary:
- Over five years, 32 pediatric patients (0.1-18 years) underwent CAPD.
- Technical survival improved from 48% to 84% after 1983.
- Key advantages include simplicity and reduced pain, enabling home dialysis even for infants.
- Severe complications like peritonitis and catheter tunnel infections were noted, but peritonitis frequency decreased to one episode per treatment year in the last two years.
Impact:
- CAPD demonstrates improved technical survival and patient acceptance in pediatric ESRD.
- Adequate patient/parent training and regular standardized follow-up in specialized units are crucial for successful CAPD outcomes.
- This study highlights the potential of CAPD for home-based renal replacement therapy in young patients.
Abstract:
Continuous ambulatory peritoneal dialysis (CAPD) is a relatively new blood purification method applicable as an alternative to intermittent hemodialysis in the treatment of end-stage renal disease. In this report we discussed the results of more than five years of CAPD in 32 children and adolescents aged 0.1 to 18 years treated for up to 22 months as well as the advantages and disadvantages of this technique in comparison to hemodialysis. Technical survival after one year of treatment increased from 48% in patients treated before 1983 to 84% in patients treated thereafter. Simplicity of technical procedure and lack of pain are considered the major advantages. Thus home dialysis can be performed even under adverse conditions (e.g. in infants). Infections of the abdominal cavity and the catheter tunnel are severe complications of CAPD. In the course of the last two years the frequency of peritonitis dropped to one episode per treatment year. We want to stress that successful treatment can be achieved by adequately training patients and their parents to perform home dialysis on their own and by surveying patients regularly according to standardized treatment guidelines in a pediatric nephrology unit.