[Clinical investigations of children with chronic renal failure and peritonitis treated with peritoneal dialysis].
Peritonitis and catheter-related infection are the most-common complications of peritoneal dialysis treatment. The aim of study was to analyse frequency causes, effectiveness of therapy and risk factors of peritonitis in patients treated with continuous peritoneal dialysis (CAPD). We described 13 patients aged 6-21 years, mean 12 years, who initiated CAPD between 1995 to 2000. The most-common primary cause of end-stage renal disease were chronic glomerulonephritis in 8 children, renal dysplasia in 3 children, hemolytic-uremic syndrome in 1 child and obstruction uropathy in 1 child. Peritonitis rate was 1 episode for 9 patient months. Staphylococcus aureus was the most-common infection factor. We performed exchange of catheter in 8 children. Causes of exchange were exit site infection, cuff excision, tunnel infection and peritonitis. Children were usually treated with two antibiotics for two weeks. Effect of treatment was better in these episodes treated longer than two weeks. As a risk factors of increasing peritonitis relapses we suggest immunosuppressive therapy, protein deficiency, catheter dislocation, not adequate education of patient family and chronic skin infections. We observed lower rate of peritonitis relapses in patients treated longer than two years on CAPD.


CONCLUSIONS
1. In patients with chronic renal failure treated with CAPD the preceding immunosupressive therapy increases the frequency of peritonitis. 2. More intensive treatment can cause decreasing frequency of peritonitis relapses. 3. Some risk factors increase the frequency of peritonitis relapses. 4. A better education of patient and his family decreases the frequency of peritonitis relapses.
Stefaniak
Ewa
E
Klinika Kardiologii i Nefrologii Dzieciecej Instytutu Pediatrii AM w Poznaniu.
Warzywoda
Alfred
A
Błaszczyński
Michał
M
Zachwieja
Jacek
J
Niklas
Arkadiusz
A
Maciejewski
Janusz
J
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents; D002648:Child; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010353:Patient Education as Topic; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D011044:Poland / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013997:Time Factors
D000900:Anti-Bacterial Agents