"Flush before fill" in children receiving automated peritoneal dialysis.
OBJECTIVE
To evaluate the impact of the "flush before fill" technique on the frequency of peritonitis in children receiving automated peritoneal dialysis (APD).


METHODS
Randomized prospective multicenter study.


METHODS
Participating pediatric dialysis programs of the Pediatric Peritoneal Dialysis Study Consortium.


METHODS
121 pediatric (< 21 years of age) patients that had received peritoneal dialysis for > or = 2 months and that were currently receiving APD were randomized to use (flush group) or non-use (no flush group) of the "flush before fill" option. 66 patients were followed for > or = 12 months.


METHODS
Peritonitis rates.


RESULTS
Overall, patients enrolled in the flush group experienced a peritonitis rate of 1 infection every 16.8 patient months; patients in the no flush group experienced a rate of 1 infection every 12.6 patient months (p = 0.193). However, analysis by gender revealed the peritonitis rate of females in the flush group (1 infection every 44.7 patient months) to be significantly better than females in the no flush group (1 infection every 12.4 patient months) (p < or = 0.01). There was no difference noted in the male patients.


CONCLUSIONS
The use of the "flush before fill" option in pediatric patients receiving APD is associated with a marked improvement in the peritonitis rate of female but not male patients. Further study is indicated to explain the gender differences.
Warady
Bradley A
BA
Children's Mercy Hospital, Kansas City, Missouri 64108, USA. bwarady@cmh.edu
Ellis
Eileen N
EN
Fivush
Barbara A
BA
Lum
Gary M
GM
Alexander
Steven R
SR
Brewer
Eileen D
ED
Ogrinc
Frank
F
Watkins
Sandra L
SL
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods*; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies