Pediatric Nephrology

, Volume 28, Issue 2, pp 315–319

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

  • N. M. Dolan
  • D. Borzych-Duzalka
  • A. Suarez
  • I. Principi
  • O. Hernandez
  • S. Al-Akash
  • L. Alconchar
  • C. Breen
  • M. Fischbach
  • J. Flynn
  • L. Pape
  • J. J. Piantanida
  • N. Printza
  • W. Wong
  • J. Zaritsky
  • F. Schaefer
  • B. A. Warady
  • C. T. White
Original Article

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.

Keywords

Pediatric Renal replacement therapy Spina bifida Hydrocephalus Intraperitoneal pressure 

References

  1. 1.
    Harambat J, van Stralen KJ, Kim JJ, Tizard EJ (2012) Epidemiology of chronic kidney disease in children. Pediatr Nephrol 27:363–373PubMedCrossRefGoogle Scholar
  2. 2.
    Schaefer F, Warady BA (2011) Peritoneal dialysis in children with end-stage renal disease. Nat Rev Nephrol 7:659–668PubMedCrossRefGoogle Scholar
  3. 3.
    Manning TC, Avellino AM, Symons J, Ojemann J, Ellenbogen RG (2008) Cerebrospinal fluid shunting in children on renal dialysis. Report of two cases. Pediatr Neurosurg 44:65–67PubMedCrossRefGoogle Scholar
  4. 4.
    Kari JA (2006) Neuropathic bladder as a cause of chronic renal failure in children in developing countries. Pediatr Nephrol 21:517–520PubMedCrossRefGoogle Scholar
  5. 5.
    Warady BA, Hellerstein S, Alon U (1990) Advisability of initiating chronic peritoneal dialysis in the presence of a ventriculoperitoneal shunt. Pediatr Nephrol 4:96PubMedCrossRefGoogle Scholar
  6. 6.
    Kazee MR, Jackson EC, Jenkins RD (1990) Management of a child on CAPD with a ventriculoperitoneal shunt. Adv Perit Dial 6:281–282PubMedGoogle Scholar
  7. 7.
    Ram Prabahar M, Sivakumar M, Chandrasekaran V, Indhumathi E, Soundararajan P (2008) Peritoneal dialysis in a patient with neurogenic bladder and chronic kidney disease with ventriculoperitoneal shunt. Blood Purif 26:274–278PubMedCrossRefGoogle Scholar
  8. 8.
    Grunberg J, Rebori A, Verocay MC (2003) Peritoneal dialysis in children with spina bifida and ventriculoperitoneal shunt: one center’s experience and review of the literature. Perit Dial Int 23:481–486PubMedGoogle Scholar
  9. 9.
    Grunberg J, Verocay MC, Rebori A, Pouso J (2007) Comparison of chronic peritoneal dialysis outcomes in children with and without spina bifida. Pediatr Nephrol 22:573–577PubMedCrossRefGoogle Scholar
  10. 10.
    North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) (2011) Annual dialysis report. NAPRTCS, Boston. http://web.emmes.com/study/annlrept/annualrept2011.pdf.
  11. 11.
    Avery RA, Shah SS, Licht DJ, Seiden JA, Huh JW, Boswinkel J, Ruppe MD, Chew A, Mistry RD, Liu GT (2010) Reference range for cerebrospinal fluid opening pressure in children. N Engl J Med 363:891–893PubMedCrossRefGoogle Scholar
  12. 12.
    Fischbach M, Warady BA (2009) Peritoneal dialysis prescription in children: bedside principles for optimal practice. Pediatr Nephrol 24:1633–11642PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2012

Authors and Affiliations

  • N. M. Dolan
    • 1
  • D. Borzych-Duzalka
    • 2
    • 3
  • A. Suarez
    • 4
  • I. Principi
    • 5
  • O. Hernandez
    • 6
  • S. Al-Akash
    • 7
  • L. Alconchar
    • 8
  • C. Breen
    • 9
  • M. Fischbach
    • 10
  • J. Flynn
    • 11
  • L. Pape
    • 12
  • J. J. Piantanida
    • 13
  • N. Printza
    • 14
  • W. Wong
    • 15
  • J. Zaritsky
    • 16
  • F. Schaefer
    • 2
  • B. A. Warady
    • 17
  • C. T. White
    • 1
  1. 1.ACB K4-151, NephrologyBC Children’s HospitalVancouverCanada
  2. 2.Center for Children and Adolescent MedicineHeidelbergGermany
  3. 3.Medical University of GdanskGdanskPoland
  4. 4.Servicio de Nefrología Hospital de Niños Sor Marí a LudovicaLa PlataArgentina
  5. 5.Hospital Pediatrico Humberto NottiMendozaArgentina
  6. 6.Instituto Nacional del RiñonBogotaColombia
  7. 7.Driscoll Children’s HospitalCorpus ChristiUSA
  8. 8.Unidad de Nefrología Pediátrica del Hospital Interzonal GeneralBahia BlancaArgentina
  9. 9.The Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  10. 10.Children’s Dialysis CenterStrasbourgFrance
  11. 11.Seattle Children’s HospitalSeattleUSA
  12. 12.Medizinische HochschuleHannoverGermany
  13. 13.Hospital de Niños Ricardo GutierrezBuenos AiresArgentina
  14. 14.Pediatric Nephrology UnitAristoteles UniversityThessalonikiGreece
  15. 15.Starship Children’s HospitalAucklandNew Zealand
  16. 16.UCLA Medical CenterLos AngelesUSA
  17. 17.Children’s Mercy HospitalKansas CityUSA

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