Intraperitoneal pressure measurements in children: a retrospective study

Area of Science:

• Nephrology
• Pediatrics
• Dialysis

Background:

• Peritoneal dialysis (PD) requires individualized regimens for optimal clinical tolerance and adequacy.
• Intraperitoneal pressure (IPP) measurements are proposed for determining optimal intraperitoneal dialysate volume (IPV), but routine clinical data are limited.

Purpose of the Study:

• To evaluate the applicability and variability of routine intraperitoneal pressure (IPP) measurements in children on automated peritoneal dialysis (APD).
• To assess the relationship between IPP, intraperitoneal dialysate volume (IPV), and PD-related complications in a pediatric population.

Main Methods:

• Retrospective analysis of 655 monthly IPP measurements from 21 children on stable automated PD.
• IPP was measured during daytime (IPP1) and nighttime (IPP2) dwell volumes using various dialysis fluids.
• Measurements were correlated with PD-related complications and Kt/V.

Main Results:

• Mean IPP was 11.0 ± 2.6 cmH2O, with higher values observed during nighttime dwells (IPP2) compared to daytime dwells (IPP1).
• IPP increased with higher fill volumes per body surface area (BSA).
• Significant intra- and interindividual variability in IPP was noted with single fill volume measurements.

Conclusions:

• IPP values were acceptable in the studied pediatric population.
• Higher fill volumes correlated with higher IPP.
• The clinical significance of IPP variability and its direct relation to patient outcomes remains uncertain.