[Chronic peritoneal dialysis: an alternative to iterative hemodialysis].
27 children, aged 7 months to 15 years, with terminal renal failure and no available vascular access, were treated with chronic peritoneal dialysis for 3 weeks to 9 months (mean 3 months). An indwelling silicon catheter fitted with a subcutaneous dacron felt cuff was used; the average catheter life time was 10 weeks (3 to 25 weeks). Control of uremia was satisfactory with mean serum urea decreasing from 2 to 1 g/l and creatinine from 130 mg/l to 60 mg/l after 48 hours of dialysis. No uremic complications occured. Total serum protein remained stable: mean: 62 g/l prior to treatment and 60 g/l after the treatment period. Hematocrit was higher than in hemodialysed children (17% versus 15%). Three children were directly transplanted without difficulty. However, some complications did occur. There were 27 episodes of catheter obstruction leading to 12 surgical interventions. 18 episodes of peritonitis (5% of total dialyses) occured in 12 patients, and two were lethal. The frequency of complications prohibits a recommendation of chronic peritoneal dialysis over hemodialysis in children; this technique however remains very helpful in those situations where vascular access is difficult.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006437:Hemodialysis, Home; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation; D007688:Kidneys, Artificial; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014184:Transplantation, Homologous
La dialyse peritoneale chronique: alternative de l'hemodialyse iterative chez l'enfant.