Abstract
Chronic peritoneal dialysis (CPD) has been utilized in the treatment of children since 1989 in Turkey. The aims of this study were to summarize our experience with CPD in children and to establish a pediatric registry data system in Turkey. Standard questionnaires were sent to all pediatric CPD centers. 514 patients treated between 1989 and 2002 in 12 pediatric centers were enrolled in the study. Reflux nephropathy was the most common (18.1%) cause of renal failure. Mean age at dialysis initiation was 10.1±4.6 years. Mean duration of dialysis was 24.1±20.5 months. Continuous ambulatory peritoneal dialysis (CAPD) was the first CPD modality for 476 (92.6%) patients, 142 of whom switched to automated peritoneal dialysis (APD) during follow-up. Currently, 47.3% of the patients are still on CPD, 15.4% were transplanted, 13.2% switched to hemodialysis, 16.7% died. The patient and technique survivals were 90% and 95% at one year and 70% and 69% at five years, respectively. The survival was significantly shorter in the youngest age group (0–24 months) compared to those in older age groups (p=0.000). We herein report the first results of the TUPEPD study providing information on demographic data and survival of pediatric CPD patients. As opposed to clear recommendations in favor of APD, there is a clear preponderance of CAPD in our pediatric CPD population. That vesicoureteral reflux (VUR) is still the leading cause of renal failure is a distressing finding. Remarkably lower survival rates and transplantation ratios are as striking and distressing as the high incidence of VUR among the causes of ESRD. We conclude that we must make a great effort to achieve better results and to change these undesirable events.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alexander SR, Honda M (1993) Continuous peritoneal dialysis for children: a decade of worldwide growth and development. Kidney Int 43(Suppl 40):S65–74
Warady BA, Alexander SR, Balfe JW, Harvey E (2000) Perironeal dialysis in children. In: Gokal R, Khanna R, Krediet R, Nolph K (eds) Textbook of peritoneal dialysis, 2nd edn. Kluwer, Dordrecht, pp 667–708
Alexander SR, Donaldson LA, Sullivan EK (1998) CAPD/CCPD for children in North America: The NAPRTCS experience. In: Fine RN, Alexander SR, Warady BA (eds) CAPD/CCPD in children, 2nd edn. Kluwer, Boston, MA, pp 1–16
Conover WJ (1980) Practical nonparametric statistics, 2nd edn. Wiley, New York, pp 229–239
Guo A, Mujias S (2003) Patient and technique survival on peritoneal dialysis in the United States: evaluation in large incident cohorts. Kidney Int Suppl 88:S3–12
Leonard MB, Donaldson DA, Ho M, Geary DF (2003) A prospective cohort study of incident maintenance dialysis in children: an NAPRTC study. Kidney Int 63:744–755
Verrina E, Edefonti A, Gianoglio B, Rinaldi S, Sorino P, Zacchello G, Lavoratti G, Maringhini S, Pecoraro C, Calevo MG, Turrini Dertenois L, Perfumo F (2004) A multicenter experience on patient and technique survival in children on chronic dialysis. Pediatr Nephrol 19:82–90
Hattori S, Yosioka K, Honda M, İto H (on behalf of the Japanese Society for Pediatric Nephrology) (2002) The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol 17:456–461
Edefonti A, Verrina E, Schaefer F, Fischbach M, Watson A (1998) The european experience with CAPD/CCPD in children. In: Fine RN, Alexander SR, Warady BA (eds) CAPD/CCPD in children, 2nd edn. Kluwer Academic Publishers, Boston, MA, pp 17–33
Risdon RA, Yeung CK, Ransley PG (1993) Reflux nephropathy in children submitted to unilateral nephrectomy: a clinicopathological study. Clin Nephrol 40:308–14
Honda M (1999) The 1997 Report of the Japanese National Registry data on pediatric peritoneal dialysis patients. Periton Dialysis Int 19(Suppl 2):S473–8
Verrina E, Perfumo F, Calevo MG, Rinaldi S, Sorino P, Andreetta B, Bonaudo R, Lavoratti G, Edefonti A (1999) The Italian Pediatric Chronic Peritoneal Dialysis Registry. Periton Dialysis Int 19(Suppl 2):479–483
Schaefer F, Klaus G, Muller-Wiefel DE, Mehls O (1999) Current practice of peritoneal dialysis in children: results of a longitudinal survey. Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS). Periton Dialysis Int 19(Suppl 2):S445–9
Fine RN, Ho M (2002) The role of APD in the management of pediatric patients: A report of the North American Pediatric Renal Transplant Cooperative Study. Semin Dialysis 15:427–429
Alexander SR (1999) Pediatric end-stage renal disease. Am J Kidney Dis 34:S102–113
Honda M (1999) The role of the pediatric nephrologist (in Japanese). Kidney Dialysis 47:451–457
Neu AM, Ho PL, McDonald RA, Warady BA (2002) Chronic dialysis in children and adolescents. The 2001 NAPRTCS Annual Report. Pediatr Nephrol 17:656–663
Wood EG, Hand M, Briscoe DM, Donaldson LA, Yiu V, Harley FL, Warady BA, Ellis EN (North American Pediatric Renal Transplant Cooperative Study) (2001) Risk factors for mortality in infants and young children on dialysis. Am J Kidney Dis 37:573–579
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bakkaloglu, S.A., Ekim, M., Sever, L. et al. Chronic peritoneal dialysis in Turkish children: a multicenter study. Pediatr Nephrol 20, 644–651 (2005). https://doi.org/10.1007/s00467-004-1773-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-004-1773-9