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Immune function of children on dialysis

  • Chapter
Pediatric Dialysis

Abstract

Children with chronic renal failure (CRF) are at high risk for infectious complications. This can be attributed to the uremic state itself but also to the dialysis treatment. Peritoneal dialysis (PD) is the most commonly used method of pediatric dialysis because of its safety and simplicity. However, peritonitis remains one of the major complications of this treatment. The most common reasons for dialysis modality termination are infections when the child is not transplanted1. Nearly 50% of children have had at least one peritonitis episode at the end of the first year on PD. The standardized mortality rate remains high in children with end-stage renal disease (ESRD)1,2. The younger the child the higher the mortality risk. The primary reported causes of death in ESRD children are cerebro- and cardiovascular disease and infections1,2. The treatment and the prevention of infections are important elements in the care of pediatric dialysis patients, both for reduction of mortality and morbidity, and also for preservation of the peritoneal membrane function. Previous reports have shown that the incidence of peritonitis in children is higher than that found in adults3’4. Furthermore, it has been demonstrated that infants and children up to 6 years of age develop peritonitis more frequently than older children1. Besides technical causes for developing peritonitis in PD children, disturbances in the local intra-peritoneal, or systemic host defense might be involved in the individual infectious susceptibility5.

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  1. A. H. M. Bouts
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  2. J. C. Davin
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Editors and Affiliations

  1. Children’s Mercy Hospital, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA

    Bradley A. Warady

  2. University Children’s Hospital, Heidelberg, Germany

    Franz S. Schaefer

  3. Health Science Center, State University of New York at Stony Brook, Stony Brook, NY, USA

    Richard N. Fine

  4. Lucille Packard Children’s Hospital at Stanford, Stanford University, School of Medicine, Stanford, CA, USA

    Steven R. Alexander

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Bouts, A.H.M., Davin, J.C. (2004). Immune function of children on dialysis. In: Warady, B.A., Schaefer, F.S., Fine, R.N., Alexander, S.R. (eds) Pediatric Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1031-3_22

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  • DOI: https://doi.org/10.1007/978-94-007-1031-3_22

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