Kinetics of CCPD in Children

Abstract

Since the introduction of continuous cycling peritoneal dialysis (CCPD) in 1980 by Diaz-Buxo et al. [1], it has been the preferred dialytic modality with increasing frequency for adults as well as children with end stage renal disease (ESRD) [2–4]. Several advantages, such as the decreased incidence of peritonitis because of the reduction in the number of manual connections or the increased freedom allowing all procedures to be performed at night at home, have made this modality increasingly attractive. CCPD incorporates prolonged dwell times with fewer breaks in the sterile system and an automated cycler that provides several nocturnal cycles and, in some instances, a single daytime dwell. In order to prescribe an appropriate dialysis regimen for each patient, an understanding of the movement of solute and water through the peritoneal membrane is crucial. In children, it is especially important to determine how differences in the body size and age influence the kinetics of the transport processes. A study was therefore conducted to define the optimal prescription for maximal dialysis efficiency in children undergoing CCPD. The effect of different flow rates with constant exchange volumes on peritoneal clearances of urea, creatinine, and protein losses into dialysate were analyzed.