title: Factors associated with peritoneal dialysis catheter complications in children.
abstract: OBJECTIVE
  Peritoneal dialysis (PD) is a common method of renal replacement therapy for children. However, placement of PD catheters has risk, and some are never used.
  
  
  METHODS
  We conducted a retrospective chart review of children with a PD catheter placed between 2000 and 2014. Logistic regression analyses were used to identify covariates associated with complications.
  
  
  RESULTS
  We identified 175 children with PD catheters. 110 complications developed in 80 children (45.7%). Complications including unexpected return to the operating room and peritonitis increased as the length of time a catheter was in place increased. Children who weighed <12.4 kg had 3.2 times greater odds of developing a leak (95% CI 1.21-8.63, p=0.02). Twelve children never used their PD catheters, 9 with acute kidney injury (AKI) who recovered from their disease more quickly than expected. No covariate was associated with nonuse.
  
  
  CONCLUSIONS
  Complications with PD catheters are common and increase the longer catheters are in place. Lower weight children are at greater risk of PD catheter leak. Decreased initial volumes of dialysate in smaller children may mitigate this risk. Nonuse may be reduced if dialysis is permitted the day of placement for children with AKI.
authors.affiliation: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80045, USA. Electronic address: Camille.Stewart@UCDenver.edu.
authors.forename: Camille L
authors.initials: CL
authors.lastname: Stewart
authors.affiliation: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80045, USA.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Acker
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, 12631 E. 17th Ave., CO 80045, USA; Department of Biostatistics and Informatics, University of Colorado School of Public Health, 13001 E 17th Pl., Aurora, CO 80045, USA.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Pyle
authors.affiliation: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80045, USA; Division of Pediatric Surgery, Children's Hospital Colorado, 13123 East 16th Ave., Aurora, CO 80045, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Kulungowski
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, 12631 E. 17th Ave., CO 80045, USA; Division of Pediatric Nephrology, Children's Hospital Colorado, 13123 East 16th Ave., Aurora, CO 80045, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Cadnapaphornchai
authors.affiliation: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80045, USA; Division of Pediatric Surgery, Children's Hospital Colorado, 13123 East 16th Ave., Aurora, CO 80045, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bruny
authors.affiliation: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80045, USA; Division of Pediatric Surgery, Children's Hospital Colorado, 13123 East 16th Ave., Aurora, CO 80045, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Karrer
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy; D000293:Adolescent; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015314:Dialysis Solutions / Q000008:administration & dosage; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation*; D010538:Peritonitis / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D015314:Dialysis Solutions
keywords: Pediatric peritoneal dialysis; Pediatric renal replacement therapy