title: The importance of ultrasonographic measurement of peritoneal wall thickness in pediatric chronic peritoneal dialysis patients.
abstract: Loss of peritoneal function due to peritoneal fibrosing syndrome (PFS) is a major factor leading to treatment failure in chronic peritoneal dialysis (PD) patients. Although the precise biologic mechanisms responsible for these changes have not been defined, the general assumption is that alterations in peritoneal function are related to structural changes in the peritoneal membrane. Studies of the peritoneal membrane by non-invasive ultrasonography (US) in chronic PD patients are limited. The aim of the present study is to assess the relationship between functional parameters of peritoneum and peritoneal thickness measured by US in children treated by chronic PD. We recruited two groups of patients: 23 subjects (13 females, 10 males) on chronic PD (patient group) and 26 (7 females, 19 males) on predialysis out-patient follow-up (creatinine clearance: 20-60 mL/min/1.73 m(2)) (control group). Age, sex, weight, height, body mass index (BMI), chronic PD duration, episodes of peritonitis and the results of peritoneal equilibration test (PET) were recorded. Hemoglobin (Hb), blood pressure (BP), left ventricular mass index (LVMI) and renal osteodystrophy (ROD) parameters were also obtained. The thickness of the parietal peritoneum was measured by trans-abdominal US in all children. Statistical analyses were performed by using Student's t and Pearson's correlation tests. Mean peritoneal thickness in chronic PD patients (1028.26 ± 157.26 μm) was significantly higher than control patients (786.52 ± 132.33). Mean peritoneal thickness was significantly correlated with mean body height (R(2) = 0.93, p < 0.05), BMI (R(2) = 0.25, p < 0.05), chronic PD duration (R(2) = 0.64, p < 0.05), episodes of peritonitis (R(2) = 0.93, p < 0.05), D/Pcreatinine (R(2) = 0.76, p < 0.05) and D4/D0glucose (R(2) = 0.81, p < 0.05). No correlation was found between peritoneal thickness and Hb, BP, LVMI and ROD parameters. In conclusion, ultrasonographic measurement of peritoneal membrane thickness is a simple and non-invasive method in chronic PD children. This diagnostic tool likely enables to assess peritoneal structure and function in these patients.
authors.affiliation: Department Pediatric Nephrology, Izmir Tepecik Training and Research Hospital , Izmir , Turkey .
authors.forename: Önder
authors.initials: Ö
authors.lastname: Yavaşcan
authors.forename: Nejat
authors.initials: N
authors.lastname: Aksu
authors.forename: Caner
authors.initials: C
authors.lastname: Alparslan
authors.forename: Serdar
authors.initials: S
authors.lastname: Sarıtaş
authors.forename: Cengiz Han
authors.initials: CH
authors.lastname: Elmas
authors.forename: Ali Nihat
authors.initials: AN
authors.lastname: Eraslan
authors.forename: Soner
authors.initials: S
authors.lastname: Duman
authors.forename: Sevgi
authors.initials: S
authors.lastname: Mir
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D056627:Peritoneal Fibrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results; D017211:Treatment Failure; D014421:Turkey; D014463:Ultrasonography
keywords: Chronic peritoneal dialysis; pediatric; peritoneal wall thickness; ultrasound