Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

Ambarsari, Cahyani Gita; Trihono, Partini Pudjiastuti; Kadaristiana, Agustina; Tambunan, Taralan; Mushahar, Lily; Puspitasari, Henny Adriani; Hidayati, Eka Laksmi; Pardede, Sudung O.

doi:10.13181/mji.v28i4.3807

Cited by 13 publications

(29 citation statements)

References 22 publications

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“…12,[21][22][23][24] Recent case reports from our center have confirmed that pediatric cases with ESRD undergoing peritoneal dialysis often develop infection due to poor hygiene. 6 In the present study, three patients died from pneumonia, with of one of these due to cytomegalovirus reactivation. The KDIGO (Kidney Disease: Improving Global Outcomes) guideline recommends using trimethoprim/sulfamethoxazole for 3-6 months post-transplantation to prevent pneumocystis pneumonia, which can be life-threatening.…”

Section: Patient Outcomesmentioning

confidence: 45%

“…Only Case 12 had a complication, presenting with a bleed adjacent to the graft that required further surgery within 3 hours after receiving the transplant ( 2019, with kidney hypoplasia as the primary underlying disease. 6,9 However, these data likely underestimate the true prevalence of pediatric ESRD because the country has only two pediatric dialysis units located in the capital, making it extremely likely that there are many undiagnosed and untreated pediatric cases in the wider population.…”

Section: Post-transplantation Outcomes and Follow-upmentioning

confidence: 99%

“…c DGF was defined as the presence of needs for dialysis within the first seven days after kidney transplantation. 6,7 d Graft survival (non-censored for death) was calculated from the date of transplantation up to the time when graft failure developed, which was characterized by a return to long-term dialysis, re-transplantation or the last follow-up when the transplant was still functioning or up to the date of death. In this analysis, death with functioning graft was categorized as graft failure e Death-censored graft survival: the dead patients with functioning graft on follow-up period were censored on the date of death.…”

Section: Patient Outcomesmentioning

confidence: 99%

“…5 Additionally, pediatric peritoneal dialysis has only been offered since 2014. 6 These data suggest the need to improve the service for children with kidney problems in Indonesia. To date, however, there has been no report about pediatric transplantation in Indonesia.…”

Section: Introductionmentioning

confidence: 99%

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Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study

Ambarsari

Hidayati

Trihono

et al. 2020

Pediatric Transplantation

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Background: Pediatric kidney transplantation was only introduced in Indonesia in 2013. We therefore aimed to assess the characteristics and outcomes of transplants performed from its inception to January 2019. Method: The study had a dual-center retrospective design. We examined the records of kidney transplant recipients and then calculated patient and graft survival rates by Kaplan-Meier survival analysis with 95% confidence intervals (95% CI). Results: In total, 12 kidney transplantations were performed in eleven children during the study period; among these, ten were boys, and nine had renal failure caused by congenital anomaly of the kidney or urinary tract. All donors were living, and all recipients were on dialysis at the time of transplantation, when their median age was 14.5 years (range, 8-19 years). Three patients died of infection in the first year of follow-up and two lost their allograft by the time of their last follow-up (median, 13 months; range, 4-69 months). The 1-year patient survival rate was therefore 68.18% (95% CI, 29.72%-88.61%), which remained unchanged at 3 and 5 years. However, the non-death-censored graft survival rates at 1, 3, and 5 years were 68.18% (95% CI, 29.72%-88.61%), 51.14% (95% CI, 14.5%-79.46%), and 25.57% (95% CI, 1.38%-64.78%), respectively. Conclusion: Patient and graft survival rates after pediatric kidney transplantation in Indonesia are lower than those reported in other countries. Closer patient follow-up and stricter adherence to guidelines could improve transplant outcomes, but we must seek to improve the balance between infection and rejection.

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Section: Patient Outcomesmentioning

confidence: 45%

Section: Post-transplantation Outcomes and Follow-upmentioning

confidence: 99%

Section: Patient Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study

Ambarsari

Hidayati

Trihono

et al. 2020

Pediatric Transplantation

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“…PD is the recommended treatment modality of renal replacement therapy for children with ESRD. It confers a better quality of life [3]; however, it is associated with noninfectious complications, such as catheter obstruction or malfunction, leakage, abdominal wall defect, PPF, hydrocele, ultrafiltration failure, or fluid overload [4].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Effective Management of Peritoneal Dialysis-Associated Hydrothorax in a Child: A Case Report

Ambarsari

Bermanshah

Putra

et al. 2020

Case Rep Nephrol Dial

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Peritoneal dialysis (PD) confers many advantages, including a better quality of life for children with end-stage renal disease; however, the procedure is associated with several complications, including pleuroperitoneal leaks. Here, we report an unusual case of hydrothorax caused by long-term PD in a child, which was further complicated by pneumonia. A 9-year-old boy who had received CAPD for 22 months presented with dyspnea, swelling, and increased body weight. Chest tube drainage yielded 500 mL of transudative fluid. Computed tomography peritoneography revealed increased outflow from the peritoneum to the pleural cavity. PD was suspended, and hemodialysis (HD) was initiated. Video-assisted thoracoscopic surgery was performed; however, because the patient had pneumonia during hospitalization, pleural adhesions with a septated appearance occurred. This resulted in difficulties identifying pleuroperitoneal fistula (PPF). Right pleural effusion resolved following pleurodesis using bleomycin. Ambarsari et al.: Effective Management of PD-Associated Hydrothorax in a Child 19Regular HD was performed for 10 weeks, and PD was subsequently reinitiated. There was no recurrence of hydrothorax during long-term follow-up. We suspect that the underlying mechanism of hydrothorax in our patient was associated with a PPF that formed either due to a congenital diaphragmatic defect or an acquired defect, resulting in dialysate leakage. Our case demonstrates that a temporary switch from PD to HD, accompanied by pleurodesis, may help resolve hydrothorax that occurs as a complication of long-term PD.

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Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

Cited by 13 publications

References 22 publications

Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study

Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study

Effective Management of Peritoneal Dialysis-Associated Hydrothorax in a Child: A Case Report

Epidemiology and Outcomes of Children with Kidney Failure Receiving Kidney Replacement Therapy in Australia and New Zealand

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