Fibrin glue used successfully in peritoneal dialysis catheter leakage in children.
BACKGROUND
Acute renal failure in infants and small children is generally treated with peritoneal dialysis (PD). Dialysis has to be started immediately after catheter implantation. Early dialysate leakage can complicate the effectiveness of dialysis. Fibrin glue applied to the external part of the tunnel may stop dialysate leakage and eliminate the need for surgical intervention. The use of fibrin glue in the treatment of PD catheter leakage in children was studied.


METHODS
Fibrin glue was used in 8 children (age 0.8 - 57 months) on PD in whom dialysate leakage was seen during the first 24 to 48 hours after catheter insertion. The dialysis volume initially administered was 20 mL/kg body weight. Fibrin glue (1 mL) was applied to the external part of the subcutaneous catheter tunnel through the exit site, as close to the cuff as possible. The occurrence of dialysate leakage and complications such as exit-site or tunnel infection and peritonitis were evaluated.


RESULTS
Nine single-cuff straight Tenckhoff catheters were implanted in 8 children. In 5 cases, no subcutaneous tunnel was created. One child had catheter replacement due to obstruction of the catheter; on both occasions, catheter leakage was seen and treated with fibrin glue. In all 8 patients, no relapse of dialysate leakage was seen after application of the fibrin glue. During the time of PD, exit-site infections, tunnel infections, and peritonitis did not occur.


CONCLUSIONS
Fibrin glue is a successful, simple, and safe substance for the treatment of peritoneal dialysate leakage in infants and small children with acute renal failure treated with PD.
Rusthoven
Esther
E
Department of Pediatric Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands. erusthoven@hotmail.com
van de Kar
Nicole A C J
NA
Monnens
Leo A H
LA
Schröder
Cornelis H
CH
D058186:Acute Kidney Injury / Q000628:therapy; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002675:Child, Preschool; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives