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Home peritoneal dialysis during infancy
Insights
Home peritoneal dialysis (PD) is a viable option for infants with chronic renal failure, enabling them to await transplantation. While growth failure was observed, PD was generally well-tolerated in these young patients.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Chronic Kidney Disease Management
Background:
- Infantile chronic renal failure necessitates renal replacement therapy.
- Home peritoneal dialysis (PD) offers a treatment modality for infants awaiting transplantation.
- Early initiation of PD in infants under 10 kg is feasible.
Observation:
- Two infants with end-stage renal disease initiated chronic home PD before one year of age.
- Dialysis was performed for 10 and 13 months, respectively, pending cadaveric kidney transplantation.
- Infants were monitored for growth, dialysis tolerance, and complications such as peritonitis.
Findings:
- Both infants experienced significant growth failure during home PD treatment.
- One infant had three episodes of peritonitis, while the other remained peritonitis-free for 10 months.
- Chronic home PD was considered well-tolerated overall in both cases.
Implications:
- Home PD can support infants with chronic renal failure, bridging the gap to transplantation.
- Growth failure is a notable concern requiring careful management in infants undergoing chronic PD.
- Further research is needed to optimize growth and minimize complications in pediatric PD patients.
Abstract:
We have recently trained two sets of parents to perform home peritoneal dialysis on their infants with chronic renal failure. Chronic dialysis was initiated before the age of one year with a body weight of less than 10 kg. The infants were maintained on dialysis for 10 and 13 months respectively awaiting cadaveric transplantation. Both infants had marked growth failure while on chronic home dialysis. Although one infant had three episodes of peritonitis, the other had none during 10 months of dialysis. Chronic home peritoneal dialysis was well tolerated in both infants.