Peritoneal dialysis in the prune belly syndrome.
OBJECTIVE
To describe our experience with chronic ambulatory peritoneal dialysis in children with the prune belly syndrome (PBS).


METHODS
From our peritoneal dialysis (PD) program we were able to review the medical records of 6 boys with PBS. Data were collected on potential complications such as infections, hernias, growth, and problems encountered with PD catheter insertion.


RESULTS
The ages of the 6 boys ranged from 10 months-17 years. The dialysis duration was from 9-22 months, with a total of 76 patient-months on PD. There was one death, possibly as a complication of an exit-site infection. Five received a renal transplant, and 4 have functioning grafts. Peritonitis occurred once in every 10.8 patient-months, and exit-site or tunnel infection was diagnosed every 7.6 patient-months. Four patients required PD catheter replacement because of tunnel infection in 2, persistent exit-site infection in 1, and fluid leakage in 1. Of a total of nine catheters, three were inserted using a laparoscopic technique. There were no leaks in these three; however, there was one exit-site infection. Two patients had inguinal hernias that required surgery.


CONCLUSIONS
Deficiency of abdominal musculature in PBS poses potential problems for the use of PD, in particular, catheter anchorage, exit-site healing, and leakage. In our patients the most serious complications were infections of the exit site or catheter tunnel. Our experience suggests that a laparoscopic technique may provide improved catheter placement. PD offers a potentially successful form of dialysis for patients with PBS.
Crompton
C H
CH
Division of Nephrology, University of Toronto, Hospital for Sick Children, Ontario, Canada.
Balfe
J W
JW
Khoury
A
A
D000009:Abdominal Muscles / Q000601:surgery; D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications; D015314:Dialysis Solutions / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage; D006128:Growth / Q000502:physiology; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010538:Peritonitis / Q000209:etiology; D011535:Prune Belly Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology
D015314:Dialysis Solutions; D005947:Glucose