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NDT Advance Access first published online on February 28, 2008
This version published online on April 4, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn035
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© The Author [2008]. The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org


Peritoneal dialysis in children under two years of age

Hanne Laakkonen1, Tuula Hölttä1, Tuula Lönnqvist2, Christer Holmberg1 and Kai Rönnholm1

1 Department of Paediatric Nephrology and Transplantation, University of Helsinki, Helsinki, Finland 2 Department of Paediatric Neurology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

Correspondence and offprint requests to: Hanne Laakkonen, Department of Paediatric Nephrology and Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. email: hanne.laakkonen{at}hus.fi



  Abstract

Background. Although results of peritoneal dialysis (PD) in small children have improved during recent years, the youngest children have poorer growth, more infections and higher mortality than do older children.

Methods. In this retrospective study, we analysed patient records of all children under age 2 treated with continuous peritoneal dialysis (CPD) between 1995 and 2000 in Finland. Diagnoses leading to renal failure in these 23 children were congenital nephrotic syndrome of the Finnish type (13), polycystic kidney disease (4), a urethral valve (3), renal insufficiency due to neonatal asphyxia (2) and Prune-Belly syndrome (1). Of these 23, 17 (74%) were anuric.

Results. The mean age at the onset of PD was 0.4 years and the mean time on dialysis 1.4 years. Hernias were diagnosed in 57%. The peritonitis rate was 1:14.5 patient-months, and 30% were peritonitis-free. Hypertension was common, and 70% had at least one period on antihypertensive medication. None of the patients had pulmonary oedema or dialysis-related seizures. The mean height standard deviation score (hSDS) at the start of PD (n = 16) was –2.0 and after 9 months –1.6. Catch-up growth was documented in 64% of the patients during dialysis. Hospitalization time was 124 days/patient-year. Two patients (9%) died.

Conclusions. Our results are reassuring. Mortality was low, laboratory parameters were acceptable and growth was good. Peritonitis rate was comparable to that in older children. Correction of inguinal hernia should be routinely performed; high blood pressure is still a problem.

Keywords: children; complications; infant; outcome; peritoneal dialysis

Received for publication: 14. 2.07
Accepted in revised form: 18. 1.08


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