The optimal approach to peritoneal dialysis prescription in children.
OBJECTIVE
To describe the optimal approach to peritoneal dialysis (PD) prescription in children.


METHODS
Review of the available literature.


RESULTS
Unlike the situation in adults, the main method used for PD in children is automated peritoneal dialysis (APD). The prone position, while resting, permits the dialysis prescription to use a higher fill volume (IPV), as in continuous ambulatory peritoneal dialysis (CAPD), and is also probably more effective than PD in an upright position. However, because APD is limited to 10 hours, the dialytic effectiveness of nocturnal APD should avoid two potential risks: (1) use of too high an IPV per exchange, inducing lymphatic reabsorption, a factor in unsuitable water and sodium balance [Fischbach M. Peritoneal dialysis prescription for neonates. Perit Dial Int. 1996; 16(Suppl):S52-4]; and (2) use of too short a dwell time per exchange, limiting the purification of creatinine and phosphate despite an apparently adequate urea purification (Malhotra C, Murota GH, Tzamaloukas AH. Creatinine clearance and urea clearance in PD: What to do in case of discrepancy. Perit Dial Int. 1997; 17:532-5).
Fischbach
M
M
Nephrology Dialysis Transplantation, Children's Unit, Strasbourg, France.
Terzic
J
J
Bergère
V
V
Gaugler
C
C
Provot
E
E
D001692:Biological Transport; D002648:Child; D003404:Creatinine / Q000378:metabolism; D006801:Humans; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods; D010537:Peritoneum / Q000378:metabolism; D014508:Urea / Q000378:metabolism
D014508:Urea; D003404:Creatinine