A Down Syndrome Patient Treated by Peritoneal Dialysis

Hausmann, Michael; Landau, Daniel

doi:10.1159/000063317

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…Our patients have a mild impairment with GFR, and thus, conservative treatment was carried out and no biopsy performed. Renal transplantation is found to be a reasonable option in end-stage renal failure treatment for DS patients [34], and it seems to be the preferred treatment modality, although a few pediatric cases of DS on dialysis have been reported [35]. Nonetheless, the absence of other serious medical problems, level of psychomotor development and family support also must be taken into account in order to choose the best treatment option when the patient develops endstage renal disease [36].…”

Section: Discussionmentioning

confidence: 99%

Renal involvement in Down syndrome

S¹,

Pardo

Málaga

et al. 2005

Pediatr Nephrol

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Kidney disease has not been considered a frequent complication in Down syndrome (DS) patients; a variety of urological abnormalities and glomerulopathies have been reported in this population, and some DS patients develop chronic renal failure (CRF). The aim of this study was to improve the understanding of renal disease in patients with DS, focusing on the incidence and range of kidney and urological abnormalities in a population of DS patients. A cross-sectional study was carried out in DS patients referred from a pediatric genetics unit of a tertiary care center. Medical records were reviewed. A 24-h urine specimen and a blood sample were obtained. Fractional excretion of sodium and potassium, tubular reabsorption of phosphate, urinary excretion of calcium, magnesium, uric acid, creatinine clearance and proteinuria were determined. Ultrasound was performed to evaluate the kidneys and the urinary tract. Laboratory data were reviewed for any possible renal disorder. Sixty-nine patients, aged 12 months to 24 years, were recruited. Pathological findings included three cases of voiding disturbances and a case of hypertension in a 7-year old girl. Eight patients (11.6%) had hyperuricemia without gout. Eighteen patients (24.2%) had hyperuricosuria. Urinalysis revealed three cases of mild proteinuria and two patients with microscopic hematuria. Minor radiological abnormalities were found in five patients (7.3%). Three patients (4.5%) had CRF. Renal disease in patients with DS is not as rare as previously thought, although the majority of findings are of minor relevance. According to the variety of pathologies, and in order to detect early irreversible renal injury, it seems quite reasonable to perform regular monitoring of renal function in these patients.

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Section: Discussionmentioning

confidence: 99%

Renal involvement in Down syndrome

S¹,

Pardo

Málaga

et al. 2005

Pediatr Nephrol

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“…3 The most common renal anomalies involve kidney and urinary tract malformations, hypoplastic or dysplastic renal disease, posterior urethral valve, vesicourethral reflux accompanied by hypercalcemia, hypercalciuria, and medullary calcinosis, focal segmental glomerulosclerosis, and chronic membranous glomerulonephritis. 1,2,4,5 In this case, a combination of the renal and mental handicaps was the dominant problem. The other usual…”

Section: Discussionmentioning

confidence: 74%

“…2,6 It is preferable to use renal transplantation as the renal replacement method. 1 From 1987 to 1995, the North American Pediatric Renal Transplant Cooperative Study followed 14 Down syndrome patients with renal transplants; there were 4 pre-emptive transplants.…”

Section: Renal Replacement In Down Syndrome Patientsmentioning

confidence: 99%

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A Down syndrome patient treated with peritoneal dialysis

Horčička

Zadrazil

Zahálková

et al. 2006

Dialysis & Transplantation

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BackgroundDown syndrome patients are not always suited for peritoneal dialysis, mainly due to their lack of compliance with the procedure. We report a case of a 42‐year‐old male Down syndrome patient successfully treated with peritoneal dialysis.MethodsThe patient suffered from end‐stage renal disease caused by chronic pyelonephritis due to a dysplastic urinary tract. Comorbid conditions included hypothyroidism, hypertension, hyperlipidemia, malnutrition with obesity, left ventricle dysfunction, multiple corneal erosions, and glaucoma. Because, in this case, the patient's mother would be required to sit full time at his bedside during a hemodialysis procedure, a peritoneal dialysis program was preferred. The treatment was complicated by peritoneal catheter dysfunction leading to the prolongation of the draining out time and the need to change the position of the body during drainage in the 29th month of treatment.ResultsThree months later, when the patient became overhydrated and a dry ultrafiltration procedure in the hemodialysis unit became necessary, the peritoneal catheter was replaced, which solved this problem.ConclusionAlthough the peritoneal dialysis procedure in mentally retarded patients is prone to failure mainly because of an increased risk of peritonitis and a burn‐out syndrome among their parents, this patient's mother has been successfully treating him by for more than 4 years without a single episode of peritonitis.

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“…Mental retardation in the PD patient further increase dependence, and hence, parents are often constrained by family commitments. The primary caregiver for a patient who is not self-sufficient in a CPD program is therefore exposed to burnout syndrome (11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%