[Infectious complications in children with end-stage renal disease on replacement therapy].
BACKGROUND
Annually, 5000 children younger than 20 years of age and 200 younger than two-years require treatment for chronic kidney disease (CKD). The objective was to estimate the incidence rate of infectious complications in children requiring renal replacement therapy.


METHODS
Retrospective cohort. Patients with a minimum of three months of follow-up in programs of peritoneal dialysis and hemodyalisis were included. The incidence rate for infections associated to replacement therapy was calculated.


RESULTS
67 patients were analysed. In 88 %, initial therapy for CKD was peritoneal dialysis. A total of 52 episodes of peritonitis occured, with an incidence rate of 0.63 episodes/patient-year. Thirty children (48 %) never had an episode of peritonits during the folow-up. At six months, 90 % of the children had the same peritoneal dialysis catheter, decreasing to 84, 74 and 50 % at 12, 18 and 24 months, respectively. Forty-five children were on hemodialysis, 82 % preceded by peritoneal dialysis. Dialysis treatment time in 25 % of them was longer than 19 months. Twenty-two episodes of catheter-related bacteremia occurred, with an incidence rate of 1 episode/1000 catheter-days or 2.5/1000 hemodyalisis sesions. Twenty-nine patients received a transplant (43 %); two of them died. Median waiting time to transplant was 15 months.


CONCLUSIONS
Incidence rate of infectious complications was similar to the rates reported in the literature by other centers. At 20 months, half of the patients had at least one infectious complication.
Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. guadalumiranda@terra.com.mx.
Néstor Daniel
ND
Robles-Vázquez
María Alejandra
MA
Aguilar-Kitsu
Leticia
L
Mendoza-Guevara
María Guadalupe
MG
Miranda-Novales
D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology*; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008800:Mexico; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology*; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
Chronic kidney failure; Dialysis; Peritoneal dialysis