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Related Experiment Videos

One-step peritoneal catheter replacement in children

I Goldraich1, M Mariano, N Rosito

  • 1Department of Pediatrics, Hospital de Clínicas de Porto Alegre, Brazil.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1993
PubMed
Summary

Replacing peritoneal dialysis catheters in children can now be done without stopping treatment. This one-step surgical method avoids complications from temporary hemodialysis, ensuring continuous care for pediatric patients.

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Area of Science:

  • Pediatric Nephrology
  • Surgical Innovation

Background:

  • Catheter replacement in pediatric peritoneal dialysis (PD) often requires treatment interruption.
  • Discontinuation of PD poses challenges with vascular access and hemodialysis in children.

Purpose of the Study:

  • To evaluate the safety and efficacy of a one-step, uninterrupted catheter replacement procedure in pediatric patients undergoing continuous ambulatory peritoneal dialysis (CAPD).

Main Methods:

  • A 5-year retrospective study involving 9 pediatric patients (4 infants, 2 preschool, 3 school-age) requiring 15 peritoneal access device replacements.
  • All procedures were performed surgically under general anesthesia as a one-step removal and replacement.
  • Postoperative management included prophylactic antibiotics and adjusted fluid exchange volumes to maintain low intra-abdominal pressure.

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Main Results:

  • No patient required interruption of CAPD or interval hemodialysis.
  • Successful catheter replacement was achieved in all cases, with only one episode of tunnel infection relapse within 2 months.
  • No recurrence of peritonitis was observed during the follow-up period.

Conclusions:

  • One-step peritoneal catheter replacement is a safe and effective strategy for pediatric patients on CAPD.
  • This technique avoids treatment disruption, preventing the need for hemodialysis and maintaining continuous PD therapy.