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Ventriculoperitoneal shunts in children on peritoneal dialysis: a survey of the International Pediatric Peritoneal Dialysis Network

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Abstract

Objective

The aim of this study was to inform best evidence-based practice by collating and disseminating the experiences of members of the International Pediatric Peritoneal Dialysis Network with children having concurrent ventriculoperitoneal shunts (VPS) and peritoneal dialysis catheters (PDC).

Methods

An online questionnaire was created and distributed to all 135 centers participating in the International Pediatric Peritoneal Dialysis Network; the overall response rate was 56 %.

Results

A total of 18 patients with a concurrent VPS and PDC were reported. The children were 0–12 (mean 6.8) years old at the time of placement of the second indwelling device (PDC or VPS). In 15 cases, the PDC was inserted post-VPS. On average, the two catheters were present concurrently for 23 (range 1–60) months. There were 20 episodes of peritonitis observed in 11 of the 18 patients during a period of 392 months at risk, which is a peritonitis rate of 1/19.6 months. Only one patient developed both a VPS infection and an episode of peritonitis, and these events were temporally unrelated. No episodes of an ascending shunt infection or meningitis occurred in association with any episode of peritonitis, and no other complications of catheter dysfunction were described.

Conclusions

The rate of peritonitis, the absence of any documented ascending or descending infections and the lack of catheter dysfunction during the period of observation suggests that the presence of, or need for, a VPS should not preclude PD as a safe option for children requiring renal replacement therapy.

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Author information

Authors and Affiliations

  1. ACB K4-151, Nephrology, BC Children’s Hospital, 4480 Oak St, Vancouver, B.C., V6H 3V4, Canada

    N. M. Dolan & C. T. White

  2. Center for Children and Adolescent Medicine, Heidelberg, Germany

    D. Borzych-Duzalka & F. Schaefer

  3. Medical University of Gdansk, Gdansk, Poland

    D. Borzych-Duzalka

  4. Servicio de Nefrología, Hospital de Niños Sor Marí a Ludovica, La Plata, Argentina

    A. Suarez

  5. Hospital Pediatrico Humberto Notti, Mendoza, Argentina

    I. Principi

  6. Instituto Nacional del Riñon, Bogota, Colombia

    O. Hernandez

  7. Driscoll Children’s Hospital, Corpus Christi, TX, USA

    S. Al-Akash

  8. Unidad de Nefrología Pediátrica del Hospital Interzonal General, Bahia Blanca, Argentina

    L. Alconchar

  9. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    C. Breen

  10. Children’s Dialysis Center, Strasbourg, France

    M. Fischbach

  11. Seattle Children’s Hospital, Seattle, WA, USA

    J. Flynn

  12. Medizinische Hochschule, Hannover, Germany

    L. Pape

  13. Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina

    J. J. Piantanida

  14. Pediatric Nephrology Unit, Aristoteles University, Thessaloniki, Greece

    N. Printza

  15. Starship Children’s Hospital, Auckland, New Zealand

    W. Wong

  16. UCLA Medical Center, Los Angeles, CA, USA

    J. Zaritsky

  17. Children’s Mercy Hospital, Kansas City, KS, USA

    B. A. Warady

Authors
  1. N. M. Dolan
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  2. D. Borzych-Duzalka
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  3. A. Suarez
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  4. I. Principi
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  5. O. Hernandez
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  6. S. Al-Akash
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  7. L. Alconchar
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  8. C. Breen
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  9. M. Fischbach
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  10. J. Flynn
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  11. L. Pape
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  12. J. J. Piantanida
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  13. N. Printza
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  14. W. Wong
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  15. J. Zaritsky
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  16. F. Schaefer
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  17. B. A. Warady
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  18. C. T. White
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Corresponding author

Correspondence to C. T. White.

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Dolan, N.M., Borzych-Duzalka, D., Suarez, A. et al. Ventriculoperitoneal shunts in children on peritoneal dialysis: a survey of the International Pediatric Peritoneal Dialysis Network. Pediatr Nephrol 28, 315–319 (2013). https://doi.org/10.1007/s00467-012-2303-9

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  • DOI: https://doi.org/10.1007/s00467-012-2303-9

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