Temporary peritoneal dialysis in newborns and children: a single-center experience over five years.
OBJECTIVE
To evaluate the indications, complications, and outcomes of temporary peritoneal dialysis (TPD) in children with acute renal failure (ARF).


METHODS
All patients undergoing TPD between February 2006 and January 2011 in a children's hospital were included in the study. Patient characteristics, indications, complications, and duration of TPD (DPD), requirement of re-operation, length of stay, presence of sepsis, and outcome were recorded.


RESULTS
There were 21 newborns (14 prematures), 9 infants, and 9 children. The main nephrotoxic agents were gentamicin (n = 7), netilmisin (n = 5), vancomycin (n = 3), and ibuprophen (n = 3). Patients with multiorgan failure (n = 9) had significantly higher blood urea nitrogen (BUN) and creatinine levels than those without multiorgan failure (n = 30) [BUN: 94 ± 27.3 vs. 34.3 ± 4.9) and creatinine: 4.1 ± 0.8 vs. 1.9 ± 0.2)]. The mean DPD was longer in mature patients than in prematures (newborn: 3.7; children: 7.1). Nine complications were observed (23%) (leakage in three and poor drainage in six patients). Twenty-five patients (64.1%) responded to TPD treatment and were discharged, and 14 patients (10 newborns and 7 of them were premature) died (35.9%). Mortality rate was higher in prematures (n = 7) and patients with a history of nephrotoxic agent (n = 10).


CONCLUSIONS
TPD is effective especially in neonates with ARF and it is a reliable alternative to the hemodialysis or other continuous renal replacement therapies but it is not free of complications. It has limited effects, particularly in patients with multiorgan failure.
Department of Pediatric Nephrology, Ondokuz Mayis University, Samsun, Turkey.
Gurkan
G
Genc
Unal
U
Bicakci
Mithat
M
Gunaydin
Burak
B
Tander
Canan
C
Aygun
Ozan
O
Ozkaya
Riza
R
Rizalar
Ender
E
Ariturk
Sukru
S
Kucukoduk
Ferit
F
Bernay
D058186:Acute Kidney Injury / Q000097:blood / Q000628:therapy*; D001806:Blood Urea Nitrogen; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014508:Urea / Q000097:blood*
D014508:Urea; D003404:Creatinine