title: Chronic peritoneal dialysis in Turkish children: a multicenter study.
abstract: Chronic peritoneal dialysis (CPD) has been utilized in the treatment of children since 1989 in Turkey. The aims of this study were to summarize our experience with CPD in children and to establish a pediatric registry data system in Turkey. Standard questionnaires were sent to all pediatric CPD centers. 514 patients treated between 1989 and 2002 in 12 pediatric centers were enrolled in the study. Reflux nephropathy was the most common (18.1%) cause of renal failure. Mean age at dialysis initiation was 10.1+/-4.6 years. Mean duration of dialysis was 24.1+/-20.5 months. Continuous ambulatory peritoneal dialysis (CAPD) was the first CPD modality for 476 (92.6%) patients, 142 of whom switched to automated peritoneal dialysis (APD) during follow-up. Currently, 47.3% of the patients are still on CPD, 15.4% were transplanted, 13.2% switched to hemodialysis, 16.7% died. The patient and technique survivals were 90% and 95% at one year and 70% and 69% at five years, respectively. The survival was significantly shorter in the youngest age group (0-24 months) compared to those in older age groups (p=0.000). We herein report the first results of the TUPEPD study providing information on demographic data and survival of pediatric CPD patients. As opposed to clear recommendations in favor of APD, there is a clear preponderance of CAPD in our pediatric CPD population. That vesicoureteral reflux (VUR) is still the leading cause of renal failure is a distressing finding. Remarkably lower survival rates and transplantation ratios are as striking and distressing as the high incidence of VUR among the causes of ESRD. We conclude that we must make a great effort to achieve better results and to change these undesirable events.
authors.affiliation: Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, 06500, Ankara, Turkey. sevcan@gazi.edu.tr
authors.forename: Sevcan A
authors.initials: SA
authors.lastname: Bakkaloglu
authors.forename: Mesiha
authors.initials: M
authors.lastname: Ekim
authors.forename: Lale
authors.initials: L
authors.lastname: Sever
authors.forename: Aytul
authors.initials: A
authors.lastname: Noyan
authors.forename: Nejat
authors.initials: N
authors.lastname: Aksu
authors.forename: Sema
authors.initials: S
authors.lastname: Akman
authors.forename: Atilla H
authors.initials: AH
authors.lastname: Elhan
authors.forename: Fatos
authors.initials: F
authors.lastname: Yalcinkaya
authors.forename: Ayse
authors.initials: A
authors.lastname: Oner
authors.forename: Orhan D
authors.initials: OD
authors.lastname: Kara
authors.forename: Salim
authors.initials: S
authors.lastname: Caliskan
authors.forename: Ali
authors.initials: A
authors.lastname: Anarat
authors.forename: Ruhan
authors.initials: R
authors.lastname: Dusunsel
authors.forename: Osman
authors.initials: O
authors.lastname: Donmez
authors.forename: Ayfer Gur
authors.initials: AG
authors.lastname: Guven
authors.forename: Aysin
authors.initials: A
authors.lastname: Bakkaloglu
authors.forename: Yasemen
authors.initials: Y
authors.lastname: Denizmen
authors.forename: Oguz
authors.initials: O
authors.lastname: Soylemezoglu
authors.forename: Gul
authors.initials: G
authors.lastname: Ozcelik
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D010530:Peritoneal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D012042:Registries; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000401:mortality
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