SON 20 YILDA YENİDOĞAN VE SÜT ÇOCUĞUNDA PERİTON DİYALİZİ: TEK MERKEZ DENEYİMİ
Year 2024,
Volume: 87 Issue: 2, 127 - 133, 27.03.2024
Bağdagül Aksu
,
Zeynep Yürük Yıldırım
,
Meltem Bor
,
Beril Yaşa
,
Leyla Bilgin
,
Nevin Uygur
,
Alev Yılmaz
Abstract
Amaç: Bir yaş altında akut ve kronik periton diyalizi uygulanan hastaları 20 yıllık süreçte etiyoloji, komplikasyon ve prognoz açısından değerlendirmek ve akut ve kronik periton diyalizinin ilk ve son on yıllık dönemleri arasındaki sonuçları karşılaştırmak.
Gereç ve Yöntem: Hastanemiz Çocuk Nefroloji ve Yenidoğan Yoğun Bakım Ünitesi'nde Ocak 2002 ile Aralık 2023 tarihleri arasında yatan bir yaş altı 74 periton diyalizi hastası retrospektif olarak değerlendirildi. Hastalar 2002-2013 döneminde başvuran hastalar (Grup I) ve 2013-2023 döneminde başvuran hastalar (Grup II) olmak üzere iki gruba ayrıldı. Grup I ve Grup II'deki hastalar akut ve kronik periton diyalizi hastalığının etiyolojisi, komplikasyonları ve prognozu açısından karşılaştırıldı.
Bulgular: Hastaların 44’ü (%60) yenidoğan, geri kalan 30'u sütçocuğu (%40) idi. Grup I'de 39 hasta, Grup II'de ise 35 hasta vardı. Akut diyaliz için Grup I ve Grup II arasında yenidoğan ve sütçocuğu tanıları, enfeksiyöz ve enfeksiyöz olmayan komplikasyonlar ve prognoz açısından fark yoktu (p>0,05). Kronik diyaliz için Grup I ve Grup II arasında yenidoğan ve sütçocuğu tanıları, enfeksiyöz ve enfeksiyöz olmayan komplikasyonlar ve sütçocuğu prognozu açısından fark yoktu (p>0,05). Grup II’deki yenidoğanlarda ölüm yoktu ve hasta sağ kalımı Grup I’deki yenidoğanlara göre daha yüksekti (p=0,019).
Sonuç: Periton diyalizi, hem akut hem de kronik böbrek yetmezliği ile karşı karşıya olan çocuklarda renal replasman tedavisi için en sık kullanılan yöntemdir. Son on yılda, yenidoğan bakım ünitesindeki yüksek kaliteli bakıma, olumlu teknolojik gelişmelere ve PD'deki etkin yönetime rağmen, önceki 10 yılda olduğu gibi en sık görülen enfeksiyöz komplikasyon hala peritonit, enfeksiyöz olmayan komplikasyon ise diyalizat kaçağıydı.
Ethical Statement
Yazarlar çıkar çatışması olmadığını beyan etmişlerdir.
Supporting Institution
Finansal olarak destekleyen herhangi bir kurum yoktur.
Thanks
Periton diyaliz hemşirelerimiz Hatice Sevgi Koç , Yasemin Kaplan , Satıgül Karakaya ve Erdal Ekin‘e emekleri için teşekkür ediyorum.
References
- Lee MM, Chua AN, Yorgin PD. Neonatal peritoneal dialysis. Neoreviews 2005;8:384-91. [CrossRef] google scholar
- Hansson JH, Watnick S. Update on peritoneal dialysis: Core Curriculum 2016. Am J Kidney Dis 2016;67(1):151-64. [CrossRef] google scholar
- Radtke J, Schild R, Reismann M, Ridwelski RR , Kempf C, Nashan B, et al. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department. J Pediatr Surg 2018;53(4):640-3. [CrossRef] google scholar
- Fraser N, Hussain FK, Connell R, Shenoy MU. Chronic peritoneal dialysis in children. Int J Nephrol Renovasc Dis 2015;8:125-37. [CrossRef] google scholar
- Borzych-Duzalka D, Aki TF, Azocar M, White C, Harvey E, Mir S, et al. International Pediatric Peritoneal Dialysis Network (IPPN) Registry. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes. Clin J Am Soc Nephrol 2017;12(1):105-12. [CrossRef] google scholar
- Korbet, SM. Acute Peritoneal Dialysis Prescription. In: Daugirdas, JT, Blake, PG (eds). Handbook of Dialysis, 4th edition. Lippincott Williams & Wilkins, Philadelphia 2007:382. google scholar
- Warady BA, Feneberg R, Verrina E, Flynn JT, Müller-Wiefel DE, Besbas N, et al. IPPR. Peritonitis in children who receive long-term peritoneal dialysis: a prospective evaluation of therapeutic guidelines. J Am Soc Nephrol 2007;18:2172-9. [CrossRef] google scholar
- 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;32:32-86. [CrossRef] google scholar
- Piraino B, Bernardini J, Sorkin M: The influence of peritoneal catheter exit site infections on peritonitis, tunnel infections, and catheter loss in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1986;8:436-40. [CrossRef] google scholar
- Khanna R, Krediet R.T. Nolphand Gokal’sTextbook of Peritoneal Dialysis. Third edition. Springer-Verlag New York 2008:42-5. google scholar
- North American Pediatric Renal Trials and Collaborative Studies (NARPTCS). 2011 Annual Report. http://www. narptcs.org. google scholar
- Coulthard MG, Vernon B. Managing acute renal failure in very low birthweight infants. Arch Dis Child 1995;73:187-92. [CrossRef] google scholar
- Drukker A. International Perinatal Nephrology Symposium 20-21 June 2001, Lausanne, Switzerland. Pediatr Nephrol 2002;17(2):133-8. [CrossRef] google scholar
- Pela I, Seracini D, Donati MA, Lavoratti G, Pasquini E, Materassi M. Peritoneal dialysis in neonates with inborn errors of metabolism: is it really out of date? Pediatr Nephrol 2008;23(1):163-8. [CrossRef] google scholar
- Hakan N, Aydin M, Zenciroglu A, Aydog O, Erdogan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: a 7-year single-center experience at tertiary neonatal intensive care unit in Turkey. Am J Perinatol 2014;31(4):335-8. [CrossRef] google scholar
- Matthews DE, West KW, Rescorla FJ, Vane DW, Grosfeld JL, Wappner RS, et al. Peritoneal dialysis in the first 60 days of life. J Pediatr Surg 1990;25(1):110-5. [CrossRef] google scholar
- Gozmen ŞK, Olukman O, Celik K, Çalkavur S, Arslanoglu S, Serdaroglu E. An efficient method for renal replacement therapy in newborn: Acute peritoneal dialysis. J Gynecology - Obstetrics and Neonatology 2017;14(1):18-21. google scholar
- Zaritsky J, Warady BA. Peritoneal dialysis in infants and young children. Semin Nephrol 2011;31(2):213-24. [CrossRef] google scholar
- Stewart CL, Acker SN, Pyle LL, Kulungowski A, Cadnapaphornchai M, Bruny JL, et al. Factors associated with peritoneal dialysis catheter complications in children. J Pediatr Surg 2016;51(1):159-62. [CrossRef] google scholar
- Blowey DL, McFarland K, Alon U, McGraw-Houchens M, Hellerstein S, Warady BA. Peritoneal dialysis in the neonatal period: outcome data. J Perinatol 1993;13(1):59-64. google scholar
- Rheault MN, Rajpal J, Chavers B, Nevins TE. Outcomes of infants < 28 days old treated with peritoneal dialysis for end-stage renal disease. Pediatr Nephrol 2009;24(10):2035-9. [CrossRef] google scholar
PERITONEAL DIALYSIS IN NEWBORNS AND INFANTS IN THE LAST 20 YEARS: SINGLE CENTER EXPERIENCE
Year 2024,
Volume: 87 Issue: 2, 127 - 133, 27.03.2024
Bağdagül Aksu
,
Zeynep Yürük Yıldırım
,
Meltem Bor
,
Beril Yaşa
,
Leyla Bilgin
,
Nevin Uygur
,
Alev Yılmaz
Abstract
Objective: To evaluate patients who underwent acute and chronic peritoneal dialysis under the age of one one in terms of etiology, complications, and prognosis over 20 years and to compare the results between the first and last 10 years of acute and chronic peritoneal dialysis.
Material and Method: Seventy-four peritoneal dialysis patients under the age of one in the Division of Pediatric Nephrology and Neonatal Intensive Care Unit of our hospital between January 2002 and December 2023 were evaluated retrospectively. The patients were divided into two groups: patients admitted in the 2002-2013 period (Group I) and patients admitted in the 2013-2023 period (Group II). Patients in Group I and Group II were compared in terms of acute and chronic peritoneal dialysis etiology, complications, and prognosis.
Result: Forty-four of the patients (60%) were newborns, and the remaining 30 were infants (40%). There were 39 patients in Group I and 35 patients in Group II. There was no difference between Group I and Group II for acute dialysis in terms of neonatal and infant diagnoses, infectious and non-infectious complications, and prognosis (p>0.05). There was no difference between Group I and Group II in terms of neonatal and infant diagnoses, infectious and non-infectious complications, and infant prognosis (p>0.05). There was no death in the newborns in Group II and patient survival was higher than in the newborns in Group I (p=0.019).
Conclusion: Peritoneal dialysis is the most commonly used method for renal replacement therapy in children facing both acute and chronic renal failure. In the last decade, despite high-quality care in the neonatal care unit, positive technological developments and effective management of PD, the most common infectious complication was still peritonitis, and the non-infectious complication was dialysate leakage, as in the previous 10 years.
Ethical Statement
The authors have no conflict of interest to declare
Supporting Institution
There is no financial supporting.
Thanks
I would like to thank our peritoneal dialysis nurses Hatice Sevgi Koç, Yasemin Kaplan, Satıgül Karakaya, and Erdal Ekin for their efforts.
References
- Lee MM, Chua AN, Yorgin PD. Neonatal peritoneal dialysis. Neoreviews 2005;8:384-91. [CrossRef] google scholar
- Hansson JH, Watnick S. Update on peritoneal dialysis: Core Curriculum 2016. Am J Kidney Dis 2016;67(1):151-64. [CrossRef] google scholar
- Radtke J, Schild R, Reismann M, Ridwelski RR , Kempf C, Nashan B, et al. Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: A comparative data analysis from a transplant surgical and a pediatric surgical department. J Pediatr Surg 2018;53(4):640-3. [CrossRef] google scholar
- Fraser N, Hussain FK, Connell R, Shenoy MU. Chronic peritoneal dialysis in children. Int J Nephrol Renovasc Dis 2015;8:125-37. [CrossRef] google scholar
- Borzych-Duzalka D, Aki TF, Azocar M, White C, Harvey E, Mir S, et al. International Pediatric Peritoneal Dialysis Network (IPPN) Registry. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes. Clin J Am Soc Nephrol 2017;12(1):105-12. [CrossRef] google scholar
- Korbet, SM. Acute Peritoneal Dialysis Prescription. In: Daugirdas, JT, Blake, PG (eds). Handbook of Dialysis, 4th edition. Lippincott Williams & Wilkins, Philadelphia 2007:382. google scholar
- Warady BA, Feneberg R, Verrina E, Flynn JT, Müller-Wiefel DE, Besbas N, et al. IPPR. Peritonitis in children who receive long-term peritoneal dialysis: a prospective evaluation of therapeutic guidelines. J Am Soc Nephrol 2007;18:2172-9. [CrossRef] google scholar
- 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;32:32-86. [CrossRef] google scholar
- Piraino B, Bernardini J, Sorkin M: The influence of peritoneal catheter exit site infections on peritonitis, tunnel infections, and catheter loss in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1986;8:436-40. [CrossRef] google scholar
- Khanna R, Krediet R.T. Nolphand Gokal’sTextbook of Peritoneal Dialysis. Third edition. Springer-Verlag New York 2008:42-5. google scholar
- North American Pediatric Renal Trials and Collaborative Studies (NARPTCS). 2011 Annual Report. http://www. narptcs.org. google scholar
- Coulthard MG, Vernon B. Managing acute renal failure in very low birthweight infants. Arch Dis Child 1995;73:187-92. [CrossRef] google scholar
- Drukker A. International Perinatal Nephrology Symposium 20-21 June 2001, Lausanne, Switzerland. Pediatr Nephrol 2002;17(2):133-8. [CrossRef] google scholar
- Pela I, Seracini D, Donati MA, Lavoratti G, Pasquini E, Materassi M. Peritoneal dialysis in neonates with inborn errors of metabolism: is it really out of date? Pediatr Nephrol 2008;23(1):163-8. [CrossRef] google scholar
- Hakan N, Aydin M, Zenciroglu A, Aydog O, Erdogan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: a 7-year single-center experience at tertiary neonatal intensive care unit in Turkey. Am J Perinatol 2014;31(4):335-8. [CrossRef] google scholar
- Matthews DE, West KW, Rescorla FJ, Vane DW, Grosfeld JL, Wappner RS, et al. Peritoneal dialysis in the first 60 days of life. J Pediatr Surg 1990;25(1):110-5. [CrossRef] google scholar
- Gozmen ŞK, Olukman O, Celik K, Çalkavur S, Arslanoglu S, Serdaroglu E. An efficient method for renal replacement therapy in newborn: Acute peritoneal dialysis. J Gynecology - Obstetrics and Neonatology 2017;14(1):18-21. google scholar
- Zaritsky J, Warady BA. Peritoneal dialysis in infants and young children. Semin Nephrol 2011;31(2):213-24. [CrossRef] google scholar
- Stewart CL, Acker SN, Pyle LL, Kulungowski A, Cadnapaphornchai M, Bruny JL, et al. Factors associated with peritoneal dialysis catheter complications in children. J Pediatr Surg 2016;51(1):159-62. [CrossRef] google scholar
- Blowey DL, McFarland K, Alon U, McGraw-Houchens M, Hellerstein S, Warady BA. Peritoneal dialysis in the neonatal period: outcome data. J Perinatol 1993;13(1):59-64. google scholar
- Rheault MN, Rajpal J, Chavers B, Nevins TE. Outcomes of infants < 28 days old treated with peritoneal dialysis for end-stage renal disease. Pediatr Nephrol 2009;24(10):2035-9. [CrossRef] google scholar