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Long-term outcomes in children on chronic continuous ambulatory peritoneal dialysis: a retrospective cohort study from a developing country

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Abstract

Background

Peritoneal dialysis (PD) is the preferred modality of dialysis among children with end-stage renal disease.

Methods

To study the incidence of technique failure and survival among children with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD), we included children younger than 18 years of age who commenced and continued PD for more than 3 months as their primary form of dialysis between 1st January 2005 and 31st December 2016. Kaplan–Meier survival analysis was applied to analyze the CAPD outcomes.

Results

A total of 68 Tenckhoff (58 double cuffs, and ten single cuffs) catheters were inserted in 66 patients (mean age 12.3 ± 3.91 years) during the study period. Of the 66 children, 31 (47%) experienced 45 episodes of peritonitis. The total duration on CAPD was 107.58 years with a peritonitis rate of 0.42 episodes per year. Overall, the mean patient survival was 41 (95% confidence interval (CI) 29–54) months, with mean patient survival of 72% at 12 months, declining to 30% at 36 months and then remaining stable until the end of follow-up (106 months). The overall mean technique survival was 55 (95% CI 40–69) months, with mean technique survival of 69% at 12 months, declining to 44% at 36 months and then remaining stable until the end of follow-up (106 months).

Conclusion

CAPD is a viable option for end-stage renal disease in children from developing countries with a lack of access to automated PD and pediatric hemodialysis centers.

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Acknowledgments

We acknowledge Mr. Ramesh Kumar, PD nurse, for his contribution to the success story of the PD program at the institute.

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Author notes

  1. Narayan Prasad and Dharshan Rangaswamy contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Narayan Prasad, Manas Patel, Dharmendra Bhadauria, Anupama Kaul & Amit Gupta

  2. Department of Nephrology (Pediatric), Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal (Udupi), 576104, India

    Dharshan Rangaswamy

  3. Pediatric Nephrology, Fortis Group of Hospitals, New Delhi, India

    Sanjeev Gulati

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  1. Narayan Prasad
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Correspondence to Narayan Prasad.

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The study was approved by the Institute’s ethics committee (IEC-2016-57-IP).

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Prasad, N., Rangaswamy, D., Patel, M. et al. Long-term outcomes in children on chronic continuous ambulatory peritoneal dialysis: a retrospective cohort study from a developing country. Pediatr Nephrol 34, 2389–2397 (2019). https://doi.org/10.1007/s00467-019-04311-w

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  • DOI: https://doi.org/10.1007/s00467-019-04311-w

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