The outcome for pediatric patients on peritoneal dialysis.
BACKGROUND
The adverse effects of peritonitis and of the duration of dialysis on dialysis adequacy and clinical outcome were evaluated in this study.


METHODS
The study comprised 24 chronic peritoneal dialysis patients who were followed up at least for 12 months. Casual blood pressure (BP) measurements, echocardiographic evaluation, peritonitis rate, hemoglobin (Hb), serum albumin, normalized protein catabolic rate (nPCR), total Kt/Vurea, weekly creatinine clearance (CCr), residual renal function (RRF), removal of fluid and dose of recombinant human erythropoietin (EPO) were evaluated.


RESULTS
Mean age of the patients was 15.3 +/- 3.6 years. Mean follow-up was 50.4 +/- 26.8 months. Peritonitis rate was calculated as 1 episode/32.7 patient-months. Systolic hypertension was detected in 14 patients (58%) and diastolic hypertension in 15 (63%). RRF showed a negative correlation with duration on dialysis (r=-0.623, p=0.006). There was no significant correlation between RRF and nPCR, Hb, hematocrit, albumin and dose of EPO. A negative correlation was found with left ventricular mass index and fluid removal (r=-0.461, p=0.041). Higher doses of Kt/Vurea are associated with higher protein intake (r=0.503, p=0.024). A positive correlation was found between Kt/Vurea and Hb and Hct levels (r=0.460, p=0.009, and r=0.528, p=0.017, respectively). Dialysis adequacy tests were found not to be affected by the frequency of peritonitis.


CONCLUSIONS
The most important factor for the prevention of hypervolemia in chronic peritoneal dialysis patients is RRF. The concept of adequate dialysis should include normal volume homeostasis, control of blood pressure and adequate nutrition.
Acar
Banu
B
Department of Pediatric Nephrology, Ankara University Faculty of Medicine, Ankara, Turkey. banuacar@gmail.com
Yalcinkaya
Fatoş
F
Cakar
Nilgün
N
Yüksel
Selçuk
S
Ozçakar
Zeynep Birsin
ZB
Uncu
Nermin
N
Kara
Nazli
N
Elhan
Atilla Halil
AH
Ekim
Mesiha
M
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002648:Child; D003404:Creatinine / Q000378:metabolism; D004452:Echocardiography; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010537:Peritoneum / Q000378:metabolism; D010538:Peritonitis / Q000209:etiology; D011994:Recombinant Proteins; D012709:Serum Albumin / Q000032:analysis; D014508:Urea / Q000378:metabolism; D014882:Water-Electrolyte Balance
D006454:Hemoglobins; D011994:Recombinant Proteins; D012709:Serum Albumin; D004921:Erythropoietin; D014508:Urea; D003404:Creatinine