Risk factors for catheter-related complications in pediatric peritoneal dialysis.
Catheter-related complications, including infection, dialysate leak, and malfunction, are the principal causes of peritoneal dialysis (PD) failure. To determine risk factors predisposing to these complications, we conducted a retrospective study of 90 children on chronic PD who received 127 catheters from January 1990 to December 2000. There was a significant risk for dialysate leak when PD catheters were used early (</=14 days post placement) versus delayed use (>14 days). There was no significant difference in malfunction and infection rate between early and delayed use groups. Weight and height <5th percentile, low serum albumin, and history of abdominal surgery were not associated with an increased risk of complications. History of dialysis prior to catheter placement and presence of a gastrostomy tube (G-tube) were both associated with significant infection risk. Patients </=3 years old were more likely to have a G-tube and had an increased risk of infection. We conclude that delayed use of the PD catheter led to a lower incidence of dialysate leak but had no effect on infection rate. Young age, G-tube, and history of prior dialysis are risk factors for infection. Multi-center, prospective controlled studies involving larger numbers of children are important to confirm these findings.
Rahim
Khawla A
KA
Division of Pediatric Nephrology M1-5, Children's Hospital, Regional Medical Center, 4800 Sand Point Way, NE, WA 98105, Seattle, USA.
Seidel
Kristy
K
McDonald
Ruth A
RA
D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors