Peritoneal Dialysis in Critically Ill Children

  • Hui-Kim YapEmail author
  • Lourdes Paula R. Resontoc


Acute peritoneal dialysis (PD) as a form of renal replacement therapy (RRT) in critically ill newborns and children is becoming less popular owing to the availability of a more modern and advanced RRT modalities. However, it is still useful in a subset of patients with difficult vascular access, requiring small volumes, problems with bleeding, cardiovascular and hemodynamic instability. Its technical simplicity allows it to be operated at a lower cost, thus making it a modality of choice in areas lacking in resources and man power. Slow inefficient dialysis and unpredictable ultrafiltration have been overcome with the development of cyclers, flexible catheters with bigger lumen and side holes that allows for higher dialysate flow rate and PD prescriptions that employs high volume and more frequent exchanges.


Infants Children Critically ill Acute peritoneal dialysis Renal replacement therapy Prescription 


  1. 1.
    Warady BA, Bunchman T. Dialysis therapy for children with acute renal failure: survey results. Pediatr Nephrol. 2000;15(1–2):11–3.CrossRefPubMedGoogle Scholar
  2. 2.
    Kwiatkowski DM, Menon S, Krawczeski CD, Goldstein SL, Morales DL, Phillips A, et al. Improved outcomes with peritoneal dialysis catheter placement after cardiopulmonary bypass in infants. J Thorac Cardiovasc Surg. 2015;149(1):230–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Bojan M, Gioanni S, Vouhe PR, Journois D, Pouard P. Early initiation of peritoneal dialysis in neonates and infants with acute kidney injury following cardiac surgery is associated with a significant decrease in mortality. Kidney Int. 2012;82(4):474–81.CrossRefPubMedGoogle Scholar
  4. 4.
    Alparslan C, Yavascan O, Bal A, Kanik A, Kose E, Demir BK, et al. The performance of acute peritoneal dialysis treatment in neonatal period. Ren Fail. 2012;34(8):1015–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Rainey KE, DiGeronimo RJ, Pascual-Baralt J. Successful long-term peritoneal dialysis in a very low birth weight infant with renal failure secondary to feto-fetal transfusion syndrome. Pediatrics. 2000;2000:106.Google Scholar
  6. 6.
    Yokoyama S, Nukada T, Ikeda Y, Hara S, Yoshida A. Successful peritoneal dialysis using a percutaneous tube for peritoneal drainage in an extremely low birth weight infant: a case report. Surg Case Rep. 2017;3(1):115.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Yu JE, Park MS, Pai KS. Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter. Pediatr Nephrol. 2010;25(2):367–71.CrossRefPubMedGoogle Scholar
  8. 8.
    Goldstein SL. Overview of pediatric renal replacement therapy in acute renal failure. Artif Organs. 2003;27(9):781–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Walters S, Porter C, Brophy PD. Dialysis and pediatric acute kidney injury: choice of renal support modality. Pediatr Nephrol. 2009;24(1):37–48.CrossRefGoogle Scholar
  10. 10.
    Flynn JT. Choice of dialysis modality for management of pediatric acute renal failure. Pediatr Nephrol. 2002;17:61.CrossRefPubMedGoogle Scholar
  11. 11.
    Mahale AS, Katyal A, Khanna R. Complications of peritoneal dialysis related to increased intra-abdominal pressure. Adv Perit Dial. 2003;19:130–5.PubMedGoogle Scholar
  12. 12.
    Rath B, Gopalan S, Gupta S, Puri RK, Talukdar B. Simpler tools for peritoneal dialysis of term newborns and young infants. Indian Pediatr. 1994;31(9):1131–2.PubMedGoogle Scholar
  13. 13.
    Segar WE, Gibson RK, Rhamy R. Peritoneal dialysis in infants and small children. Pediatrics. 1961;27:603–13.PubMedGoogle Scholar
  14. 14.
    Steele BT, Vigneux A, Blatz S, Flavin M, Paes B. Acute peritoneal dialysis in infants weighing less than 1500 g. J Pediatr. 1987;110(1):126–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Swan H and Gordon HH. Peritoneal lavage in the treatment of anuria in children. Pediatrics. 1949;4.Google Scholar
  16. 16.
    Mizrahia SBM, Lunskia I. Simple technique for bedside peritoneal dialysis in neonates. Nephron. 1988;48(3):258.CrossRefGoogle Scholar
  17. 17.
    Auron A, Warady BA, Simon S, Blowey DL, Srivastava T, Musharaf G, et al. Use of the multipurpose drainage catheter for the provision of acute peritoneal dialysis in infants and children. Am J Kidney Dis. 2007;49(5):650–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, et al. Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int. 2012;32(Suppl 2):S32–86.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Warchol S, Roszkowska-Blaim M, Latoszynska J, Jarmolinski T, Zachwieja J. Experience using presternal catheter for peritoneal dialysis in Poland: a multicenter pediatric survey. Perit Dial Int. 2003;23:242.PubMedGoogle Scholar
  20. 20.
    Cullis B, Abdelraheem M, Abrahams G, Balbi A, Cruz DN, Frishberg Y, et al. Peritoneal dialysis for acute kidney injury. Perit Dial Int. 2014;34(5):494–517.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Grodstein GP, Blumenkrantz MJ, Kopple JD, Moran JK, Coburn JW. Glucose absorption during continuous ambulatory peritoneal dialysis. Kidney Int. 1981;19(4):564–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Podel J, Hodelin-Wetzel R, Saha DC, Burns G. Glucose absorption in acute peritoneal dialysis. J Ren Nutr. 2000;10(2):93–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Reznik VM, Griswold WR, Peterson BM, Rodarte A, Ferris ME, Mendoza SA. Peritoneal dialysis for acute renal failure in children. Pediatr Nephrol. 1991;5(6):715–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Vasudevan A, Phadke K, Yap HK. Peritoneal dialysis for the management of pediatric patients with acute kidney injury. Pediatr Nephrol. 2017;32(7):1145–56.CrossRefPubMedGoogle Scholar
  25. 25.
    Kellum JA. Renal replacement therapy in critically ill patients with acute renal failure: does a greater dose improve survival? Nat Clin Pract Nephrol. 2007;3(3):128–9.CrossRefPubMedGoogle Scholar
  26. 26.
    VA/NIH Acute Renal Failure Trial Network, Palevsky PM, Zhang JH, O'Connor TZ, Chertow GM, Crowley ST, Choudhury D, Finkel K, Kellum JA, Paganini E, Schein RM, Smith MW, Swanson KM, Thompson BT, Vijayan A, Watnick S, Star RA, Peduzzi P. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med. 2008;359(1):7.CrossRefGoogle Scholar
  27. 27.
    Paganini EP, Tapolyai M, Goormastic M, Halstenberg W, Kozlowski L, Leblanc M, Lee JC, Moreno L, Sakai K. Establishing a dialysis therapy/patient outcome link in intensive care unit acute dialysis for patients with acute renal failure.Google Scholar
  28. 28.
    Chionh CY, Ronco C, Finkelstein FO, Soni SS, Cruz DN. Acute peritoneal dialysis: what is the 'adequate' dose for acute kidney injury? Nephrol Dial Transplant. 2010;25(10):3155–60.CrossRefPubMedGoogle Scholar
  29. 29.
    Parapiboon W, Jamratpan T. Intensive versus minimal standard dosage for peritoneal dialysis in acute kidney injury: a randomized pilot study. Perit Dial Int. 2017;37(5):523–8.CrossRefPubMedGoogle Scholar
  30. 30.
    McNiece KL, Ellis EE, Drummond-Webb JJ, Fontenot EE, O'Grady CM, Blaszak RT. Adequacy of peritoneal dialysis in children following cardiopulmonary bypass surgery. Pediatr Nephrol. 2005;20(7):972–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Sutherland SM, Zappitelli M, Alexander SR, Chua AN, Brophy PD, Bunchman TE, et al. Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. Am J Kidney Dis. 2010;55(2):316–25.CrossRefGoogle Scholar
  32. 32.
    Goldstein SL, Somers MJ, Baum MA, Symons JM, Brophy PD, Blowey D, et al. Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy. Kidney Int. 2005;67(2):653–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Passadakis PS, Oreopoulos DG. Peritoneal dialysis in patients with acute renal failure. Adv Perit Dial. 2007;23:7–16.PubMedGoogle Scholar
  34. 34.
    Gabriel DP, Caramori JT, Martim LC, Barretti P, Balbi AL. High volume peritoneal dialysis vs daily hemodialysis: a randomized, controlled trial in patients with acute kidney injury. Kidney Int Suppl. 2008;108:S87–93.CrossRefGoogle Scholar
  35. 35.
    Jiang L, Zeng R, Yang K, Mi DH, Tian JH, Ma B, et al. Tidal versus other forms of peritoneal dialysis for acute kidney injury. Cochrane Database Syst Rev. 2012;6:CD007016.Google Scholar
  36. 36.
    Chitalia VC, Almeida AF, Rai H, Bapat M, Chitalia KV, Acharya VN, et al. Is peritoneal dialysis adequate for hypercatabolic acute renal failure in developing countries? Kidney Int. 2002;61(2):747–57.CrossRefPubMedGoogle Scholar
  37. 37.
    Shinaberger JH, Shear L, Barry KG. Increasing efficiency of peritoneal dialysis: experience with peritoneal-extracorporeal recirculation dialysis. Trans Am Soc Artif Intern Organs. 1965;11:76–82.CrossRefPubMedGoogle Scholar
  38. 38.
    Sagy M, Silver P. Continuous flow peritoneal dialysis as a method to treat severe anasarca in children with acute respiratory distress syndrome. Crit Care Med. 1999;27(11):2532.CrossRefPubMedGoogle Scholar
  39. 39.
    Diaz-Buxo JA. Evolution of continuous flow peritoneal dialysis and the current state of the art. Semin Dial. 2001;15(5):373.CrossRefGoogle Scholar
  40. 40.
    Nourse P, Sinclair G, Gajjar P, du Plessis M, Argent AC. Continuous flow peritoneal dialysis (CFPD) improves ultrafiltration in children with acute kidney injury on conventional PD using a 4.25% dextrose solution. Pediatr Nephrol. 2016;31(7):1137–43.CrossRefPubMedGoogle Scholar
  41. 41.
    Raaijmakers R, Schroder CH, Gajjar P, Argent A, Nourse P. Continuous flow peritoneal dialysis: first experience in children with acute renal failure. Clin J Am Soc Nephrol. 2011;6(2):311–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PaediatricsYong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
  2. 2.Division of Paediatric Nephrology, Dialysis and Renal TransplantationKhoo Teck Puat-National University Children’s Medical Institute, National University Health SystemSingaporeSingapore

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