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A multicenter study on the hospitalization of pediatric patients on chronic peritoneal dialysis
E Verrina1, A Edefonti, F Perfumo
1Italian Registry of Pediatric Chronic Peritoneal Dialysis.
Insights
Pediatric chronic peritoneal dialysis (CPD) patients required hospitalization mainly for training and CPD-related complications. Younger children (0-2 years) experienced higher hospitalization rates than older children.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Chronic peritoneal dialysis (CPD) is a vital renal replacement therapy for children.
- Understanding hospitalization patterns is crucial for optimizing pediatric CPD care.
Purpose of the Study:
- To analyze hospitalization causes and rates in pediatric CPD patients.
- To identify factors influencing hospitalization duration and frequency.
Main Methods:
- Retrospective study of 92 children undergoing CPD from 1989-1992.
- Analysis of 1406 CPD-months and 4683 hospital days.
- Categorization of hospitalizations by cause and patient age.
Main Results:
- Hospitalization rate was 3.33 days/CPD-month, highest in the first year of treatment (4.32 days/CPD-month) due to training.
- CPD-related complications (35%) and training (31%) were primary admission reasons.
- Younger children (0-2 years) had significantly higher hospitalization rates (5.47 days/CPD-month) than older children (2.78 days/CPD-month).
- Peritonitis and catheter issues were leading CPD-related complications; hypertension and infections were key clinical complications.
Conclusions:
- Initial CPD training significantly impacts early hospitalization rates.
- CPD-related complications necessitate careful management in pediatric patients.
- Age is a significant factor in hospitalization risk for children on CPD.
Abstract:
The Italian Registry of Pediatric Chronic Peritoneal Dialysis (CPD) carried out a special study on patient hospitalization during the years 1989-1992. Ninety-two children (mean age 8.4 +/- 4.7 years) entered the study, for a total of 1406 CPD-months. The contribution of the different causes of hospitalization for a total of 4683 hospital days was: CPD training 31%; routine controls 14%; CPD-related complications 35%; clinical complications 14%; other causes 6%. The rate of patient hospitalization that resulted was 3.33 days/CPD-month; it was higher in the first year (4.32 days/CPD-month) than in the second year (1.64 days/CPD-month) or in the third year (2.25 days/CPD-month). This difference was mainly due to the need for the training at the start of the CPD treatment. The evaluation of the hospitalization rate in different age groups showed a statistically significant difference (p < 0.05) between the group 0-2 years (5.47 days/CPD-month) and the group 3-15 years (2.78 days/CPD-month). Complications were the cause of 150 admissions to the hospital (1:9.6 CPD-months). Ninety-eight admissions were due to CPD-related complications: peritonitis (33%), problems with the catheter (19%), abdominal hernias (4%), and others (9%). Among clinical complications (52 admissions), the main cause of hospitalization was hypertension (15%), followed by infections (4%), and malnutrition (3%).