Gulsah Kaya Aksoy1, Mesiha Ekim2, Sevcan A Bakkaloğlu3, Seda Coşkun4, Ali Delibaş5, Seçil Conkar6, Dilek Yılmaz7, Aslıhan Kara8, Seha K Saygılı9, Bahar Büyükkaragöz3, Zeynep Y Yıldırım10, Elif Çomak11, Metin K Gürgöze8, Lale Sever10, Aytül Noyan12, Aysun K Bayazıt13, Ruhan Düşünsel4. 1. Department of Pediatric Nephrology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey. gkayaaksoy@gmail.com. 2. Faculty of Medicine, Department of Pediatric Nephrology, Ankara University, Ankara, Turkey. 3. Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey. 4. Faculty of Medicine, Department of Pediatric Nephrology, Erciyes University, Kayseri, Turkey. 5. Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Turkey. 6. Faculty of Medicine, Department of Pediatric Nephrology, Ege University, Izmir, Turkey. 7. Faculty of Medicine, Department of Pediatric Nephrology, Adnan Menderes University, Aydin, Turkey. 8. Faculty of Medicine, Department of Pediatric Nephrology, Fırat University, Elazig, Turkey. 9. Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, Cerrahpaşa, Istanbul, Turkey. 10. Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, Istanbul, Turkey. 11. Faculty of Medicine, Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey. 12. Faculty of Medicine, Department of Pediatric Nephrology, Baskent University, Adana, Turkey. 13. Faculty of Medicine, Department of Pediatric Nephrology, Çukurova University, Adana, Turkey.
Abstract
BACKGROUND: Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related non-infectious complications and the predisposing factors. METHODS: Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated. RESULTS: A total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5-13.2) and 7.6 (IQR, 2.8-11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079-1.315, p = 0.001 and OR 1.580; 95% CI 0.660-0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%. CONCLUSIONS: Peritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely.
BACKGROUND: Peritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related non-infectious complications and the predisposing factors. METHODS: Retrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated. RESULTS: A total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5-13.2) and 7.6 (IQR, 2.8-11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079-1.315, p = 0.001 and OR 1.580; 95% CI 0.660-0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%. CONCLUSIONS: Peritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely.
Authors: Htay Htay; David W Johnson; Jonathan C Craig; Francesco Paolo Schena; Giovanni Fm Strippoli; Allison Tong; Yeoungjee Cho Journal: Cochrane Database Syst Rev Date: 2019-05-31