Peritoneal dialysis in children under two years of age

Abstract

Our results are reassuring. Mortality was low, laboratory parameters were acceptable and growth was good. Peritonitis rate was comparable to that in older children. Correction of inguinal hernia should be routinely performed; high blood pressure is still a problem.

Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

“…Provided that the results observed here are not biased by gross under-reporting, this improved outcome is likely related to better surgical technique and a decreased incidence of infectious complications due to improved exit site care and the immediate treatment of exit site infection/tunnel infections and peritonitis in accordance with published consensus treatment guidelines. The catheter survival rate was, however, significantly lower in infants compared with older children, a finding consistent with the results of other pediatric studies (12)(13)(14)(15).…”

Peritoneal dialysis and infants: further insights into a complicated relationship

“…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).…”

“…The most common complication associated with PD continues to be peritonitis, which is also the most frequent cause for hospitalization in children receiving PD [7,8]. On the basis of previous studies describing infant dialysis, cohort-specific peritonitis incidence ranges from 0.58 to 1.7 episodes per patient-year [1][2][3]. In the last annual report of the North American Pediatric Renal Trials and Collaborative studies (NAPRTCS), which includes data collected over a 20-year period, 4248 episodes of peritonitis in 6658 patient-years of follow-up were reported, yielding an annualized rate of 0.64, or one episode every 18.8 months [9].…”

Growth hormone treatment of infants with chronic kidney disease: requirement, efficacy, and safety

“…In these retrospective studies, growth in a total of 162 patients with pre-terminal chronic renal failure or requiring dialysis (hemodialysis, peritoneal dialysis) during their first year of life was analyzed [13][14][15][16][17][18]. Conservative treatment for these patients consisted of metabolic control for acidosis, electrolyte and water losses, secondary hyperparathyroidism/renal osteodystrophy (phosphate binders and vitamin D metabolites), and anemia (iron supplements, erythropoietin).…”

“…At first observation, median standardized height was already reduced to −1.8 SD. In three studies involving 42 infants on peritoneal dialysis (PD) a significant increase in standardized height was noted, and median height in these patients improved from −1.8 SD at baseline to −1.0 SD after a median observation period of 9 months [14][15][16]. Noteworthy, approximately two-thirds of the infants included in these studies originated from Finland and suffered from congenital nephrotic syndrome.…”