Çocuklarda Kronik Periton Diyalizi: On Sekiz Yıllık Tek Merkez Deneyimi

Öz

Amaç: İstanbul Üniversitesi, İstanbul Tıp Fakültesi Çocuk Nefrolojisi Bilim Dalınca 1996-2004 ve 2005-2014 yılları arasında kronik periton diyalizi PD ile tedavi edilen çocuklarda komplikasyonlar ve prognoz açısından zamanla bir değişiklik olup olmadığını değerlendirmektir. Gereç ve Yöntem: Çalışma grubu 109 hastadan oluşmaktaydı 54 kız, 55 erkek . Hastalar başvuru yıllarına göre iki gruba ayrıldı. 1996-2004 yılları arasında takip edilenler Grup 1 ve 2005-2014 yılları arasında takip edilenler Grup 2 olarak adlandırıldı. Grup 1’de 65 hasta ve Grup 2’de 44 hasta mevcuttu. Hastalar periton diyalizine bağlı komplikasyonlar ve prognoz açısından karşılaştırıldı. Bulgular: Ortalama periton diyalizine başlama yaşı Grup 1 ve Grup 2’de sırasıyla 9.5±4.2 yıl ve 7.14±5.73 yıldı. İki grupta da en sık kronik böbrek yetersizliği KBY nedeni üropatilerdi. Aletli PD yapan hasta sayısı Grup 2’de Grup 1’e göre yüksek bulundu sırası ile %73 ve %60 . Grup 1’de kateter kayıp oranı %36.9 iken, Grup 2’de bu oran %18’e düşmüştü. Her iki grupta da en sık kateter kayıp nedeni yineleyen peritonitti. Peritonit oranları Grup 2’de 1: 22.4 epizot/PD ayı Grup 1’den 1: 14.3 epizot/ PD ayı düşüktü. Her iki grupta da en sık peritonit etkeni Staphylococcus aureus olarak saptandı. İki grup arasında en dikkat çekici farklılık renal transplantasyon oranlarıydı. Grup 1’de transplantasyon oranı %7.7 iken, Grup 2’de bu oran %43.2’ye yükselmişti. Sonuç: PD’nin en önemli ve sık komplikasyonu hâlen peritonittir. PD alanındaki deneyimlerin artması ile peritonit ve kateter kayıp oranları azalmıştır

Anahtar Kelimeler

• Periton diyalizi,peritonit,PD,kateter ilişkili komplikasyon

Chronic Peritoneal Dialysis in Children: Single Center Experience Over 18 Years

Öz

Objective: The aim of the study was to evaluate whether there is a change with time regarding the complications of PD and prognosis of children treated with chronic PD between time intervals of 1996-2004 and 2005-2014.Material and Method: The study group consisted of 109 patients 54 female, 55 male . The patients were divided into two groups based on the time of their admission. The patients followed up between 1996-2004 were enrolled in Group I and those followed up between 2005-2014 were enrolled in Group II. Forty-four patients in Group II were compared to 65 children in Group I regarding PD complications and prognosis. Results: The mean ages of onset of PD was 9.5±4.2 years and 7.14±5.73 years in Group I and II, respectively. The most common cause of chronic kidney disease CKD was uropathies in both groups. The percentage of the patients on automated PD APD was higher in Group II than Group I 73% and 60%, respectively . Catheter failure rate was 18% in Group II, while the rate was 36.9% in Group I. The most frequent cause of catheter failure was recurrent peritonitis in both groups. The rate of peritonitis was lower in Group II than in Group I 1: 22.4 episode/PD months vs 1: 14.3 episode/PD months . The most common causative microorganism of peritonitis was Staphylococcus aureus in both groups. The most important difference between the two groups was the percentage of the patients who received renal transplantation. Transplantation rate was 43.2% in Group II whereas 7.7% in Group I.Conclusion: The most important complication of PD is still peritonitis. The rate of peritonitis and catheter failure has diminished as the experience in the field of PD increased

Anahtar Kelimeler

• Peritoneal dialysis,peritonitis,PD,catheterrelated complication

Kaynakça

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