Clinical experience in the treatment of infants with chronic peritoneal dialysis.
Chronic peritoneal dialysis (CPD) is the first treatment modality for most infants with end-stage renal failure; this group of patients shows peculiar clinical and technical problems. We present the data from a National Registry on 22 children starting CPD under one year of age, representing 11.6% of the total population of the Registry (189 patients). Mean weight at start of CPD was 6.1 +/- 1.8 kg and duration of dialysis was 22.1 +/- 15.5 months. During the follow-up period, 9 patients were transplanted, 1 was shifted to hemodialysis, and 4 died. Patient survival was 89.1% and 82.2% at 1 and 2 years (97.9% and 96.5% in the group of 167 older children); technique survival results were 89.1% at 1 year and 77.1% at 2 years (vs 92.5% and 85.7%, respectively). The incidence of peritonitis was 1 episode every 15.6 CPD-months (1:16.1 in the older children). Catheter-related complications occurred more frequently in infants (1:11.8 vs 1:17 episode:CPD-months), even if this difference was not statistically significant. Statural growth was on average -0.29 +/- 0.66 SD/year with a significant improvement between the first (-0.50 +/- 0.79) and the second (+0.23 +/- 0.77) year of CPD. Our data confirm that infants represent a higher risk group and that they can be treated satisfactorily with CPD while awaiting renal transplantation.
Italian Registry of Pediatric Chronic Peritoneal Dialysis, Italy.
E
E
Verrina
G
G
Zacchello
F
F
Perfumo
A
A
Edefonti
P
P
Sorino
S
S
Bassi
B
B
Andreetta
D
D
Cattarelli
G
G
Capasso
G
G
Consalvo
D002408:Catheters, Indwelling / Q000009:adverse effects; D006128:Growth; D006801:Humans; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality; D010538:Peritonitis / Q000209:etiology; D012189:Retrospective Studies