title: Ventriculoperitoneal shunts in children on peritoneal dialysis: a survey of the International Pediatric Peritoneal Dialysis Network.
abstract: OBJECTIVE
  The aim of this study was to inform best evidence-based practice by collating and disseminating the experiences of members of the International Pediatric Peritoneal Dialysis Network with children having concurrent ventriculoperitoneal shunts (VPS) and peritoneal dialysis catheters (PDC).
  
  
  METHODS
  An online questionnaire was created and distributed to all 135 centers participating in the International Pediatric Peritoneal Dialysis Network; the overall response rate was 56 %.
  
  
  RESULTS
  A total of 18 patients with a concurrent VPS and PDC were reported. The children were 0-12 (mean 6.8) years old at the time of placement of the second indwelling device (PDC or VPS). In 15 cases, the PDC was inserted post-VPS. On average, the two catheters were present concurrently for 23 (range 1-60) months. There were 20 episodes of peritonitis observed in 11 of the 18 patients during a period of 392 months at risk, which is a peritonitis rate of 1/19.6 months. Only one patient developed both a VPS infection and an episode of peritonitis, and these events were temporally unrelated. No episodes of an ascending shunt infection or meningitis occurred in association with any episode of peritonitis, and no other complications of catheter dysfunction were described.
  
  
  CONCLUSIONS
  The rate of peritonitis, the absence of any documented ascending or descending infections and the lack of catheter dysfunction during the period of observation suggests that the presence of, or need for, a VPS should not preclude PD as a safe option for children requiring renal replacement therapy.
authors.affiliation: ACB K4-151, Nephrology, BC Children's Hospital, 4480 Oak St, Vancouver, B.C., V6H 3V4, Canada.
authors.forename: N M
authors.initials: NM
authors.lastname: Dolan
authors.forename: D
authors.initials: D
authors.lastname: Borzych-Duzalka
authors.forename: A
authors.initials: A
authors.lastname: Suarez
authors.forename: I
authors.initials: I
authors.lastname: Principi
authors.forename: O
authors.initials: O
authors.lastname: Hernandez
authors.forename: S
authors.initials: S
authors.lastname: Al-Akash
authors.forename: L
authors.initials: L
authors.lastname: Alconchar
authors.forename: C
authors.initials: C
authors.lastname: Breen
authors.forename: M
authors.initials: M
authors.lastname: Fischbach
authors.forename: J
authors.initials: J
authors.lastname: Flynn
authors.forename: L
authors.initials: L
authors.lastname: Pape
authors.forename: J J
authors.initials: JJ
authors.lastname: Piantanida
authors.forename: N
authors.initials: N
authors.lastname: Printza
authors.forename: W
authors.initials: W
authors.lastname: Wong
authors.forename: J
authors.initials: J
authors.lastname: Zaritsky
authors.forename: F
authors.initials: F
authors.lastname: Schaefer
authors.forename: B A
authors.initials: BA
authors.lastname: Warady
authors.forename: C T
authors.initials: CT
authors.lastname: White
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000382:microbiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000382:microbiology*; D011475:Prosthesis Failure; D011795:Surveys and Questionnaires; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*