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Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi

Yıl 2018, Cilt: 18 Sayı: 1, 13 - 18, 01.04.2018

Zeynep Yürük Yıldırım Cemile Pehlivanoğlu Alev Yllmaz Asuman Çoban Bağdagül Aksu Sevinç Emre Ilmay Bilge Zeynep İnce Ümmiye Kavas Gülay Erden Aydan Şirin

https://doi.org/10.5222/j.child.2018.92485

Öz

Amaç: Periton diyalizi PD , yenidoğan ve sütçocuğu dönemlerinde akut ve kronik böbrek yetersizliğinde en sık uygulanan renal replasman tedavisi olmakla birlikte, uygulamada birçok sorunla karşılaşılmaktadır. Çalışmanın amacı, bu hasta grubunda PD uygulamalarında görülen sorunları belirlemektir.Gereç ve Yöntem: 2002-2013 yılları arasında bilim dalımızda 1 yaş altındayken akut veya kronik PD uygulanan 39 hastanın dosyaları retrospektif olarak incelendi. Yenidoğan ve sütçocuğu grubundaki hastalar PD uygulaması ve komplikasyonları açısından karşılaştırıldı. Bulgular: Akut PD 27 15 yenidoğan, 12 sütçocuğu hastaya uygulandı. Ortalama akut PD süresi açısından yenidoğan ve sütçocukları arasında fark yoktu 9.2±10,5 ve 11.6±13.7 gün . Komplikasyon oranları açısından yenidoğan %173.3 ve sütçocukları arasında %91.6 fark yoktu p=0.183 . Nonenfeksiyöz komplikasyonlar yenidoğanlarda daha sıktı ve en sık görülen komplikasyon kateter sızıntısıydı. Nonenfeksiyöz kompliksyonlar nedeni ile yenidoğanların %46.6’sında ve sütçocuklarının %8.3’ünde kateter yenilendi. Mortalite oranları yenidoğanlarda %66.78 n=10 , sütçocuklarında %58.3 olarak n=7 bulundu p=0.706 . Kronik PD 12 hastaya 8 yenidoğan, 4 sütçocuğu uygulandı. Kronik PD altında ortalama izlem süresi yenidoğanlarda 30.6±25.3 ay ve sütçocuklarında 23,5±23.2 aydı. Genel komplikasyonların oranı açısından iki grup arasında fark olmamakla birlikte, kateter sızıntısı, kateter obstrüksiyonu gibi nonenfeksiyöz komplikasyonlar yenidoğanlarda daha sıktı %212,5 vs %175 p=0.035 . Enfeksiyöz komplikasyonlar sütçocuklarında daha sık olmasına rağmen iki grup arasındaki fark istatistiksel olarak anlamlı bulunmadı %150 vs %112,5 p=0.646 . Mortalite oranları yenidoğanlarda %50 n=4 , sütçocuklarında %50 olarak n=2 bulundu.Sonuç: Yenidoğanlarda akut ve kronik PD’nin en sık komplikasyonu kateter sızıntısı ve obstrüksiyonu olarak saptanırken, sütçocuğunda kronik PD’de en sık komplikasyonunun peritonit olduğu saptandı

Anahtar Kelimeler

Periton diyalizi yenidoğan bebek komplikasyon

Kaynakça

  • North American Pediatric Renal Trials and Collaborative Studies (NARPTCS). 2011 Annual Report. http://www. narptcs.org(2011).
  • Coulthard MG, Vernon B. Managing acute renal failure in very low birthweight infants. Arch Dis Child. 1995;73:187-92.
  • https://doi.org/10.1136/fn.73.3.F187
  • Oxton LL, Zimmerman SW, Roecker EB, Waeken M. Risk factors for peritoneal dialysis related infections. Perit Dial Int. 1992;14:137-44.
  • Drukker A. International Perinatal Nephrology Symposium 20-21 June 2001, Lausanne, Switzerland. Pediatr Nephrol. 2002;17:133-8.
  • https://doi.org/10.1007/s00467-001-0784-z
  • 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.
  • https://doi.org/10.1007/s00467-007-0607-y
  • Patel UD, Mottes TA, Flynn JT. Delayed compared with immediate use of peritoneal catheter in pediatric peritoneal dialysis. Adv Perit Dial. 1993;17:253-9.
  • Esson ML, Quinn MJ, Hudson EL, Teitelbaum I. Subcutaneosly tunneled peritoneal dialysis catheters with delayed externalization; long-term follw-up. Adv Peit Dial. 1997;13:274-6.
  • Hakan N, Aydin M, Zenciroğlu A, Aydog O, Erdoğan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: A 7-year single center experience at a tertiary neonatal intensive care unit in Turkey. Am J Perinatol 2013
  • https://doi.org/10.1055/s-0033-134456.
  • Özkay O, Bek K. Peritoneal diaylsis in children. Turk Neph Dial Transpl. 2007;16(Suppl 2):77-85.
  • Dönmez O, Durmaz O, Ediz B, Ciğerdelen N, Kocak S. Catheter-related complications in children on chronic peritoneal dialysis. Adv Perit Dial. 2005;21;200-3.
  • Messana JM, Block GA, Swartz RD. Injury to the infe- rior epigastric artery complicating percutaneous perito- neal dialysis catheter insertion. Perit Dial Int. 2001;21:313-5.
  • Guignard JP. Renal morphogenesis and development of renal function. In: Taeusch HW, Ballard RA, ed(s). Avery’s Diseases of the Newborn. Philadelphia: WB. Saunders Company 1998:1123-30.
  • Awad H, El-Safty I, El-Barbary M, Imam S. Evaluation of renal glomerular and tubular functional and structu- ral integrity in neonates. Am J Med Sci. 2002;324: 261-6.
  • https://doi.org/10.1097/00000441-200211000-00005
  • Karlowicz MG, Adelman RD. Acute renal failure in the neonate. Clin Perinatol. 1992;19(1):139-58.
  • 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.
  • https://doi.org/10.1016/S0022-3468(05)80174-5
  • Rees L. Management of the infant with end-stage renal failure. Nephrol Dial Transplant. 2002;17:1564-7.
  • https://doi.org/10.1093/ndt/17.9.1564
  • Zaritsky J, Warady BA. Peritoneal dialysis in infants and young children. Semin Nephrol 2011;31:213-24.
  • https://doi.org/10.1016/j.semnephrol.2011.01.009
  • Vidal E, Edefonti A, Murer L, Gianoglio B, Maringhini S, Pecoraro C, et al. Peritoneal dialysis in infants: the experi- ence of the Italian Registry of Paediatric Chronic Dialysis. Nephrol Dial Transplant. 2012 Jan;27(1):388-95.
  • https://doi.org/10.1093/ndt/gfr322
  • Rahim KA, Seidel K, McDonald RA. Risk factors for catheter-related complications in pediatric peritoneal dialysis. Pediatr Nephrol. 2004;19:1021-8.
  • https://doi.org/10.1007/s00467-004-1520-2
  • Vidal E, Edefonti A, Murer L, Gianoglio B, Maringhini S, Pecoraro C, et al. Peritoneal dialysis in infants: the experi- ence of the Italian Registry of Paediatric Chronic Dialysis. Nephrol Dial Transplant. 2012 Jan;27(1):388-95.
  • https://doi.org/10.1093/ndt/gfr322
  • Shroff R, Rees L, Trompeter R et al. Long-term outco- me of chronic dialysis in children. Pediatr Nephrol. 2006;21:257-64.
  • https://doi.org/10.1007/s00467-005-2067-6
  • Wood EG, Hand M, Briscoe DM et al. Risk factors for mortality in infants and young children on dialysis: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Am J Kidney Dis 2001;37:573-9.
  • https://doi.org/10.1053/ajkd.2001.22083
  • Rheault MN, Rajpal J, Chavers B, et al. Outcomes of infants < 28 days old treated with peritoneal dialysis for end-stage renal diseas. Pediatr Nephrol. 2009 Oct;24(10):2035.
  • https://doi.org/10.1007/s00467-009-1234-6

Peritoneal Dialysis In Infants: Single Center Experience

Yıl 2018, Cilt: 18 Sayı: 1, 13 - 18, 01.04.2018

Zeynep Yürük Yıldırım Cemile Pehlivanoğlu Alev Yllmaz Asuman Çoban Bağdagül Aksu Sevinç Emre Ilmay Bilge Zeynep İnce Ümmiye Kavas Gülay Erden Aydan Şirin

https://doi.org/10.5222/j.child.2018.92485

Öz

Objective: Peritoneal dialysis PD is the most commonly used renal replacement therapy in acute and chronic renal insufficiency during neonatal and infantile periods, but many problems are encountered in practice. The aim of the study is to identify the problems seen in PD applications in this group of patients.Material and Methods: Between 2002 and 2013, files of 39 patients under 1 year of age who underwent acute or chronic PD in our department were retrospectively reviewed. Patients in the neonatal and infantile group were compared in terms of PD applications and their complications.Results: Acute PD was performed in a total of 27 patients 15 newborns, 12 infants . Mean duration of acute PD was not different in newborns and infants 9.2±10.5 vs 11.6±13.7 days . Complication rate was not different in newborns 173.3 % and in infants 91.6% p=0.183 . Non-infectious complications were more frequent in newborns and the most common complication was pericatheter leakage. The catheter was replaced in 46.6% of the newborns and in 8.3% of the infants due to non-infectious complications. Mortality rates were 66.7% n=10 in newborns and 58.3% n=7 in infants p=0.706 . Chronic PD was performed in a total 12 patients 8 newborns, 4 infants . Mean followup duration of chronic PD was 30.6±25.3 months in newborns, and 23.5±23.2 months in infants. Although overall complication rate was not different between two groups, non-infectious complications such as pericatheter leakage, and catheter obstruction were more frequent in newborns 212.5% vs 175% p=0.035 . Although infectious complications were more common in infants 150% vs 112.5% , there was no statistical significant difference between both groups p=0.646 . Mortality rates were found to be 50% n=4 in newborns and 50% n=2 in infants.Conclusion: The most important complications of acute and chronic PD in the newborns were pericatheter leakage and catheter obstruction while peritonitis was the most common problem in chronic infantile PD

Anahtar Kelimeler

Peritoneal dialysis newborn infant complication

Kaynakça

  • North American Pediatric Renal Trials and Collaborative Studies (NARPTCS). 2011 Annual Report. http://www. narptcs.org(2011).
  • Coulthard MG, Vernon B. Managing acute renal failure in very low birthweight infants. Arch Dis Child. 1995;73:187-92.
  • https://doi.org/10.1136/fn.73.3.F187
  • Oxton LL, Zimmerman SW, Roecker EB, Waeken M. Risk factors for peritoneal dialysis related infections. Perit Dial Int. 1992;14:137-44.
  • Drukker A. International Perinatal Nephrology Symposium 20-21 June 2001, Lausanne, Switzerland. Pediatr Nephrol. 2002;17:133-8.
  • https://doi.org/10.1007/s00467-001-0784-z
  • 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.
  • https://doi.org/10.1007/s00467-007-0607-y
  • Patel UD, Mottes TA, Flynn JT. Delayed compared with immediate use of peritoneal catheter in pediatric peritoneal dialysis. Adv Perit Dial. 1993;17:253-9.
  • Esson ML, Quinn MJ, Hudson EL, Teitelbaum I. Subcutaneosly tunneled peritoneal dialysis catheters with delayed externalization; long-term follw-up. Adv Peit Dial. 1997;13:274-6.
  • Hakan N, Aydin M, Zenciroğlu A, Aydog O, Erdoğan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: A 7-year single center experience at a tertiary neonatal intensive care unit in Turkey. Am J Perinatol 2013
  • https://doi.org/10.1055/s-0033-134456.
  • Özkay O, Bek K. Peritoneal diaylsis in children. Turk Neph Dial Transpl. 2007;16(Suppl 2):77-85.
  • Dönmez O, Durmaz O, Ediz B, Ciğerdelen N, Kocak S. Catheter-related complications in children on chronic peritoneal dialysis. Adv Perit Dial. 2005;21;200-3.
  • Messana JM, Block GA, Swartz RD. Injury to the infe- rior epigastric artery complicating percutaneous perito- neal dialysis catheter insertion. Perit Dial Int. 2001;21:313-5.
  • Guignard JP. Renal morphogenesis and development of renal function. In: Taeusch HW, Ballard RA, ed(s). Avery’s Diseases of the Newborn. Philadelphia: WB. Saunders Company 1998:1123-30.
  • Awad H, El-Safty I, El-Barbary M, Imam S. Evaluation of renal glomerular and tubular functional and structu- ral integrity in neonates. Am J Med Sci. 2002;324: 261-6.
  • https://doi.org/10.1097/00000441-200211000-00005
  • Karlowicz MG, Adelman RD. Acute renal failure in the neonate. Clin Perinatol. 1992;19(1):139-58.
  • 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.
  • https://doi.org/10.1016/S0022-3468(05)80174-5
  • Rees L. Management of the infant with end-stage renal failure. Nephrol Dial Transplant. 2002;17:1564-7.
  • https://doi.org/10.1093/ndt/17.9.1564
  • Zaritsky J, Warady BA. Peritoneal dialysis in infants and young children. Semin Nephrol 2011;31:213-24.
  • https://doi.org/10.1016/j.semnephrol.2011.01.009
  • Vidal E, Edefonti A, Murer L, Gianoglio B, Maringhini S, Pecoraro C, et al. Peritoneal dialysis in infants: the experi- ence of the Italian Registry of Paediatric Chronic Dialysis. Nephrol Dial Transplant. 2012 Jan;27(1):388-95.
  • https://doi.org/10.1093/ndt/gfr322
  • Rahim KA, Seidel K, McDonald RA. Risk factors for catheter-related complications in pediatric peritoneal dialysis. Pediatr Nephrol. 2004;19:1021-8.
  • https://doi.org/10.1007/s00467-004-1520-2
  • Vidal E, Edefonti A, Murer L, Gianoglio B, Maringhini S, Pecoraro C, et al. Peritoneal dialysis in infants: the experi- ence of the Italian Registry of Paediatric Chronic Dialysis. Nephrol Dial Transplant. 2012 Jan;27(1):388-95.
  • https://doi.org/10.1093/ndt/gfr322
  • Shroff R, Rees L, Trompeter R et al. Long-term outco- me of chronic dialysis in children. Pediatr Nephrol. 2006;21:257-64.
  • https://doi.org/10.1007/s00467-005-2067-6
  • Wood EG, Hand M, Briscoe DM et al. Risk factors for mortality in infants and young children on dialysis: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Am J Kidney Dis 2001;37:573-9.
  • https://doi.org/10.1053/ajkd.2001.22083
  • Rheault MN, Rajpal J, Chavers B, et al. Outcomes of infants < 28 days old treated with peritoneal dialysis for end-stage renal diseas. Pediatr Nephrol. 2009 Oct;24(10):2035.
  • https://doi.org/10.1007/s00467-009-1234-6
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makaleleri
Yazarlar

Zeynep Yürük Yıldırım Bu kişi benim

Cemile Pehlivanoğlu Bu kişi benim

Alev Yllmaz Bu kişi benim

Asuman Çoban Bu kişi benim

Bağdagül Aksu Bu kişi benim

Sevinç Emre Bu kişi benim

Ilmay Bilge Bu kişi benim

Zeynep İnce Bu kişi benim

Ümmiye Kavas Bu kişi benim

Gülay Erden Bu kişi benim

Aydan Şirin Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 18 Sayı: 1

Kaynak Göster

APA Yıldırım, Z. Y., Pehlivanoğlu, C., Yllmaz, A., Çoban, A., vd. (2018). Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi. Journal of Child, 18(1), 13-18. https://doi.org/10.5222/j.child.2018.92485
AMA Yıldırım ZY, Pehlivanoğlu C, Yllmaz A, Çoban A, Aksu B, Emre S, Bilge I, İnce Z, Kavas Ü, Erden G, Şirin A. Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi. Journal of Child. Nisan 2018;18(1):13-18. doi:10.5222/j.child.2018.92485
Chicago Yıldırım, Zeynep Yürük, Cemile Pehlivanoğlu, Alev Yllmaz, Asuman Çoban, Bağdagül Aksu, Sevinç Emre, Ilmay Bilge, Zeynep İnce, Ümmiye Kavas, Gülay Erden, ve Aydan Şirin. “Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi”. Journal of Child 18, sy. 1 (Nisan 2018): 13-18. https://doi.org/10.5222/j.child.2018.92485.
EndNote Yıldırım ZY, Pehlivanoğlu C, Yllmaz A, Çoban A, Aksu B, Emre S, Bilge I, İnce Z, Kavas Ü, Erden G, Şirin A (01 Nisan 2018) Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi. Journal of Child 18 1 13–18.
IEEE Z. Y. Yıldırım, “Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi”, Journal of Child, c. 18, sy. 1, ss. 13–18, 2018, doi: 10.5222/j.child.2018.92485.
ISNAD Yıldırım, Zeynep Yürük vd. “Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi”. Journal of Child 18/1 (Nisan 2018), 13-18. https://doi.org/10.5222/j.child.2018.92485.
JAMA Yıldırım ZY, Pehlivanoğlu C, Yllmaz A, Çoban A, Aksu B, Emre S, Bilge I, İnce Z, Kavas Ü, Erden G, Şirin A. Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi. Journal of Child. 2018;18:13–18.
MLA Yıldırım, Zeynep Yürük vd. “Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi”. Journal of Child, c. 18, sy. 1, 2018, ss. 13-18, doi:10.5222/j.child.2018.92485.
Vancouver Yıldırım ZY, Pehlivanoğlu C, Yllmaz A, Çoban A, Aksu B, Emre S, Bilge I, İnce Z, Kavas Ü, Erden G, Şirin A. Bir Yaş Altındaki Hastalarda Periton Diyalizi Uygulamaları: Tek Merkez Deneyimi. Journal of Child. 2018;18(1):13-8.