Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life

Carey, William A.; Martz, Karen; Warady, Bradley A.

doi:10.1542/peds.2015-0980

Cited by 88 publications

(66 citation statements)

References 26 publications

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“…An updated analysis in 2015 demonstrated further improved survival for neonates and infants initiating dialysis (47). While these studies must be interpreted with some caution due to selection and publication bias, they clearly show a dramatic improvement in outcomes over time.…”

Section: (35-45) a 2007 North American Pediatric Renal Trials And Comentioning

confidence: 99%

Update on Ethical Issues in Pediatric Dialysis: Has Pediatric Dialysis Become Morally Obligatory?

Wightman

Freeman

2016

CJASN

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Improvements in pediatric dialysis over the past 50 years have made the decision to proceed with dialysis straightforward for the majority of pediatric patients. For certain groups, however, such as children with multiple comorbid conditions, children and families with few social and economic resources, and neonates and infants, the decision of whether to proceed with dialysis remains much more controversial. In this review, we will examine the best available data regarding the outcomes of dialysis in these populations and analyze the important ethical considerations that should guide decisions regarding dialysis for these patients. We conclude that providers must continue to follow a nuanced and individualized approach in decision making for each child and to recognize that, regardless of the decision reached about dialysis, there is a continued duty to care for patients and families to maximize the remaining quality of their lives.

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Section: (35-45) a 2007 North American Pediatric Renal Trials And Comentioning

confidence: 99%

Update on Ethical Issues in Pediatric Dialysis: Has Pediatric Dialysis Become Morally Obligatory?

Wightman

Freeman

2016

CJASN

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“…An increasing number of publications in recent years have reported satisfactory outcomes with respect to morbidity, mortality, growth, and development in newborns and infants undergoing maintenance peritoneal dialysis (PD) [1][2][3][4][5]. A very young age at dialysis initiation still has a negative prognostic value, but this alone cannot remain a contraindication to any form of renal replacement therapy (RRT).…”

Section: Introductionmentioning

confidence: 99%

“…However, in small children, PD still represents the dialysis modality of choice [4]. Several studies indicate young age as a risk factor for infectious complications in children on dialysis.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal dialysis and infants: further insights into a complicated relationship

Vidal

2017

Pediatr Nephrol

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Peritoneal dialysis (PD) in infants represents one of the greatest challenges for pediatric nephrologists. Over recent years, positive outcome data described by several multicenter experiences and registry studies have increased the amount of information available to help determine whether to initiate a dialysis program in this high-risk patient population. There is no doubt that the rigorous implementation of strategies aimed at preventing infectious complications may have contributed to reducing the morbidity rate of these patients. However, the complex nature of infants with end-stage renal disease and the presence of multiple comorbidities still represent hallmarks that significantly impact on outcome. Although the rigorous application of improved scientific techniques can still contribute to enhancing PD results in infants, we have to acknowledge that the severity of illness in infants, especially at dialysis initiation, represents an undeniable and nonmodifiable factor.

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“…Újabb, nagy esetszámú vizsgálatok az elmúlt években fejlődésről számoltak be ezen a téren a PD-kezelés alatt álló csecsemők eredményeivel kapcsolatban. Kimondhatjuk tehát, hogy a korai életévekben a hasi dialízis a megfelelő kezelés a végállapotú veseelégte-lenné váló pácienseink kezelésére [10].…”

Section: Megbeszélésunclassified

Peritonealis dialízis gyermekkorban. A Semmelweis Egyetem I. Gyermekgyógyászati Klinikájának eredményei

et al. 2017

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Bevezetés, célkitűzés, módszer: A Semmelweis Egyetem I. Gyermekgyógyászati Klinikája hazánk legnagyobb, krónikus veseelégtelen gyermekeket ellátó centruma, ahol kiemelt szerepet kap a peritonealis dialízis alkalmazása. 2010 és 2017 között a Nemzetközi Gyermek Peritonealis Dialízis Regiszter keretében prospektív adatgyűjtés kapcsán elemeztük kezelési gyakorlatunkat. Eredmények: A fenti időszak 39 betegének átlagéletkora a kezelés indításakor 9,3 ± 6,6 év, a dialíziskezelésen töltött idő 1,3 ± 1,3 év. Veseelégtelenségük hátterében álló vezető okok a glomerulopathiák és a vese/húgyutak fejlődési rendellenességei voltak. Centrumunkban magas arányban megfigyelhetők komorbiditások, szindrómák. 18 betegünknél diagnosztizáltunk peritonitist. Laborértékeinkben eltérést az ajánlott tartományoktól parathormon-és foszfátértékekben tapasztaltunk. Gyógyszerelési statisztikáink megfeleltek az ajánlásoknak, bár bizonyos szerek hazánk-ban gyermek betegek számára nem elérhetőek. Betegeink rövid dialízisen töltött ideje a gyors transzplantációnak köszönhető. A ritka betegségek és számos komorbiditás megjelenésének oka, hogy klinikánk kiemelt gyermeknefrológiai centrum. Következtetés: Gyakorlatunk megfelel a nemzetközi irányelvekben foglaltaknak, az eltérések esetében kezeléseink egyéni átgondolására volt szükség. A nemzetközi regiszterben való részvétel saját gyakorlatunk elemzése és a terület fejlődése szempontjából kiemelt jelentőségű. Orv Hetil. 2017; 158(46): 1831-1840. Kulcsszavak: peritonealis dialízis, peritonitis, transzplantáció, dialízis, IPPN Pediatric peritoneal dialysis 1st Department of Paediatrics, Semmelweis University resultsIntroduction, aim and method: At the 1st Department of Paediatrics, Semmelweis University -the largest center for treating children with chronic kidney disease in Hungary -peritoneal dialysis has a leading role. Between 2010-2017, while being part of the International Pediatric Dialysis Network, we collected and analyzed our data in a prospective study. Beside our patients' basic data, we registered medication statistics, treatment-and laboratory results every 6 months. Results: During this period we had 39 patients on peritoneal dialysis, the average age of dialysis-initiation was 9.3 ± 6.6 years, with 1.3 ± 1.3 years spent on dialysis. The most common causes of ESRD were glomerulopathies and renal-/urinary malformations. A high rate of comorbidities was found, and in 13 cases complex syndromes. Many patients' height-and BMI SDS values differed from the normal for their age. Average glucose-monohydrate concentration was 1.6 ± 0.2%. During our investigation we used lactate-based, acidic or neutral (balanced) dialysates. Between 2010-2017 we diagnosed peritonitis in 18 of our cases. The patients were hospitalized average 70.5 ± 97.7 days. There were differences from the normal range for age in PTH-and phosphate values. Drug-statistics met the requirements of recommendations, though some medications are not available for children in Hungary. The short time spent on dialysis is due to fast-and al...

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Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life

Cited by 88 publications

References 26 publications

Update on Ethical Issues in Pediatric Dialysis: Has Pediatric Dialysis Become Morally Obligatory?

Update on Ethical Issues in Pediatric Dialysis: Has Pediatric Dialysis Become Morally Obligatory?

Peritoneal dialysis and infants: further insights into a complicated relationship

Peritonealis dialízis gyermekkorban. A Semmelweis Egyetem I. Gyermekgyógyászati Klinikájának eredményei

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