Abstract
Advanced renal failure in infancy represents a difficult therapeutic dilemma, particularly when it rapidly advances to end-stage renal disease (ESRD) during the neonatal period (1–3). Once ESRD is reached (creatinine clearance of around 5 ml/min/1.73m2), most patients require the institution of some kind of renal replacement therapy. The latter can be offered through either hemodialysis or peritoneal dialysis. Hemodialysis requires the passage of a given extracorporeal blood volume through a filter (dialyzer), and is usually performed during three weekly sessions of two to four hours duration each. Although extensively used in children, adolescents, and adults, its implementation in small infants has been limited (4). This is mainly due to the infantl’s small vessel size and circulating volume. Thus, the surgical creation of an adequate vascular access, and the presence of a large extracorporeal blood volume during dialysis, turn hemodialyis into a rather cumbersome proposition. In addition, infants are particularly susceptible to rapid transcellular volume and solute shifts (disequilibrium) (4), and the life of vascular accesses is relatively shortened as compared to larger patients. Therefore, very few infants have been maintained on hemodialysis for prolonged periods of time.
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Reference
1) Alexander SR: Chronic peritoneal dialysis in infants less than one year of age. In Fine RN and Gruskin AB (eds): End-Stage Renal Disease in Children. Philadelphia: WB Saunders Co., In Press.
Hurley JK: Kidney transplantation in infants (Letter). J Pediatr 93:538, 1978.
Dialysis and transplantation in young children (Editorial). Brit Med J 2:1033, 1979.
Mauer SM, Lynch RE: Hemodialysis techniques for infants and children. Pediatr Clin North Am 23: 843–856, 1976.
Popovich RP, Moncrief JW, Dechard JB et al: The definition of a novel portable/wearable equilibrium peritoneal dialysis technique. Am Soc Artif Inter Organs 5:64, 1976 (abstr).
Oreopoulos DG, Robson M, Izatt, S et al: A simple and safe technique for continuous ambulatory peritoneal dialysis (CAPD). Trans Am Soc Artif Intern Organs 24:484–487, 1978.
Babb A, Popovich RP, Christopher TG et al: The genesis of the square meter-hour hypothesis. Trans Am Soc Artif Intern Organs 117:81–91, 1971.
Nolph KD, Popovich RP, Moncrief JW: Theoretical and practical implications of continuous ambulatory peritoneal dialysis. Nephron 21:117–120, 1978.
Balfe JW, Vigneux A, Willumssen J et al: The use of CAPD in the treatment of children with end-stage renal disease. Perit Dial Bull 1:35–38, 1981.
Alexander SR, Tseng CH, Maksym KA et al: Clinical parameters in continuous ambulatory peritoneal dialysis for infants and children. In Moncrief JW, Popovich RP (eds): CAPD Update. New York: Masson, 1981, pp 195–207.
Kohaut E, in this volume.
Salusky JB, Lucullo L, Nelson P, Fine RN: Continuous ambulatory peritoneal dialysis in children. Pediatr Clin N Am 29: 1005–1012, 1982.
Freundlich M, Zilleruelo G, Strauss, J: Mineral metabolism in children and adults receiving continuous ambulatory peritoneal dialysis. Semin Nephrol 3:159–165, 1983.
Alexander, SR, Lubischer JT: Continuous ambulatory peritoneal dialysis in pediatrics: three years’ experience at one center. Nefrologia (Madrid) 11 (Supp 2): 53–62, 1982.
Freundlich, M, Zilleruelo G, Abitbol C et al: Peritoneal mass transfer of minerals and bone-modulating hormones in children on continuous ambulatory peritoneal dialysis., Pediatr Res 18:361 A 1984 (abstr).
Freundlich M, Zilleruelo G, Abitbol C et al: Minerals and bone modulating hormones in children on continuous ambulatory peritoneal dialysis. Nephron (In Press).
Kohaut EC, Alexander SR: ultrafiltration in the young patient on CAPD. In Moncrief JW, Popovich RP (eds): CAPD update. New York: Masson, 1981, pp 221–226.
Blumenkrantz JK, Kopple JD, Moran JK et al: Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis. Kidney Int 21:849–861, 1982.
Gokal R, Ellis HA, Ramos JM et al: Improvement in secondary hyperparathyroidism in patients on continous ambulatory peritoneal dialysis. In Gahl GM, Kessel M, Nolph KD (eds): Advances in Peritoneal Dialysis: Proceedings of the Second International Symposium on Peritoneal Dialysis, Berlin (-West), June 16–19, 1981. Amsterdam, Excerpta Medica, 1981, pp 461–466 (International Congress Series no 567)
Delmez JA, Slatopolsky E, Martin K et al: Minerals, vitamin D, and parathyroid hormone in continuous ambulatory peritoneal dialysis. Kidney Int 21:862–867, 1982.
Calderaro V, Oreopoulus DG, Meema EH, et al: Renal osteodystrophy in patients on continuous ambulatory peritoneal dialysis: A biochemical and radiological study. In Moncrief JW, Popovich RP (eds) CAPD Update, New York: Masson, 1981, pp 243–247.
Baum M. Powell D, Calvin S et al: Continuous ambulatory peritoneal dialysis in children. Comparison with hemodialysis. N Engl J Med 307:1537–1542, 1982.
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© 1986 Martinus Nijhoff Publishing, Boston
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Freundlich, M., Abitbol, C., Zilleruelo, G., Strauss, J. (1986). Continuous Peritoneal Dialysis in Infancy with Particular Emphasis on the Neonatal Period. In: Strauss, J. (eds) Homeostasis, Nephrotoxicity, and Renal Anomalies in the Newborn. Developments in Nephrology, vol 11. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2637-3_17
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DOI: https://doi.org/10.1007/978-1-4613-2637-3_17
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