Peritoneal dialysis in children.
This is a retrospective study of the course of children who received peritoneal dialysis (PD) at King Abdul Aziz Hospital, Jeddah, Saudi Arabia, from June 2000 to June 2004. A total of 15 children (9 boys and 6 girls) with end-stage renal failure (ESRF) received PD for a mean duration of 9 +/- 8.6 months; 11 children received continuous ambulatory dialysis (CAPD) and four received automated PD. The mean age of the children at the start of PD was 7.3 +/- 4.3 years. All the children had low socio-economic status. The most common complication was peritonitis (53%) followed by exit site infection (26.6%). The over all rate of peritonitis was one episode per 5.9 patients treatment months. Five children had recurrent peritonitis. Gram negative bacteria were the cause of peritonitis in 43.5% of the cases, gram positive in 30.4%, fungi in 8.9% and unknown in 17.4%. PD catheters were removed in five children; four because of infection and one because of obstruction. Three children were shifted to hemodialysis permanently, two children received renal transplantation from living donors and five children died. There was no difference in the age, duration of therapy or number of siblings, between the eight children who had peritonitis and the seven children who did not have peritonitis. However, illiteracy was higher and a separate room was less available in the peritonitis group compared to the peritonitis free group (37.5% vs 14.3% and 50% vs 100%, respectively). In conclusion; PD may still be a suitable modality of renal replacement therapy for children living in low socioeconomic conditions despite the challenging problems in them.
Kari
Jameela A
JA
Pediatrics Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.