PERITONEAL DIALYSIS IN NEWBORNS AND INFANTS IN THE LAST 20 YEARS: SINGLE CENTER EXPERIENCE

Öz

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.

Anahtar Kelimeler

• Newborn
• infant
• peritoneal dialysis

SON 20 YILDA YENİDOĞAN VE SÜT ÇOCUĞUNDA PERİTON DİYALİZİ: TEK MERKEZ DENEYİMİ

Öz

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.

Anahtar Kelimeler

• Yenidoğan
• sütçocuğu
• periton diyalizi

Kaynakça

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