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Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study

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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.

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Abbreviations

APD:

Automated peritoneal dialysis

CAKUT:

Congenital anomalies of the kidney and urinary system

CAPD:

Continuous ambulatory peritoneal dialysis

CI:

Confidence intervals

IQR:

Interquartile range

IPPN:

International Pediatric Peritoneal Dialysis Network

OR:

Odds ratios

PD:

Peritoneal dialysis

SD:

Standard deviation

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Acknowledgments

The authors acknowledge the remarkable contribution to this study of pediatric nephrologists and PD nurses who agreed to participate.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey

    Gulsah Kaya Aksoy

  2. Faculty of Medicine, Department of Pediatric Nephrology, Ankara University, Ankara, Turkey

    Mesiha Ekim

  3. Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey

    Sevcan A. Bakkaloğlu & Bahar Büyükkaragöz

  4. Faculty of Medicine, Department of Pediatric Nephrology, Erciyes University, Kayseri, Turkey

    Seda Coşkun & Ruhan Düşünsel

  5. Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, Mersin, Turkey

    Ali Delibaş

  6. Faculty of Medicine, Department of Pediatric Nephrology, Ege University, Izmir, Turkey

    Seçil Conkar

  7. Faculty of Medicine, Department of Pediatric Nephrology, Adnan Menderes University, Aydin, Turkey

    Dilek Yılmaz

  8. Faculty of Medicine, Department of Pediatric Nephrology, Fırat University, Elazig, Turkey

    Aslıhan Kara & Metin K. Gürgöze

  9. Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, Cerrahpaşa, Istanbul, Turkey

    Seha K. Saygılı

  10. Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, Istanbul, Turkey

    Zeynep Y. Yıldırım & Lale Sever

  11. Faculty of Medicine, Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey

    Elif Çomak

  12. Faculty of Medicine, Department of Pediatric Nephrology, Baskent University, Adana, Turkey

    Aytül Noyan

  13. Faculty of Medicine, Department of Pediatric Nephrology, Çukurova University, Adana, Turkey

    Aysun K Bayazıt

Authors
  1. Gulsah Kaya Aksoy
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  2. Mesiha Ekim
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  3. Sevcan A. Bakkaloğlu
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  5. Ali Delibaş
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  9. Seha K. Saygılı
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  10. Bahar Büyükkaragöz
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  11. Zeynep Y. Yıldırım
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  13. Metin K. Gürgöze
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  14. Lale Sever
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  15. Aytül Noyan
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  16. Aysun K Bayazıt
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  17. Ruhan Düşünsel
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Corresponding author

Correspondence to Gulsah Kaya Aksoy.

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Aksoy, G.K., Ekim, M., Bakkaloğlu, S.A. et al. Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study. Pediatr Nephrol 36, 417–423 (2021). https://doi.org/10.1007/s00467-020-04719-9

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  • DOI: https://doi.org/10.1007/s00467-020-04719-9

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