Indications and complications of peritoneal dialysis in children with acute renal failure, a single center experience

Abstract

Background: Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute renal failure (ARF) in children and hemodynamically unstable patients, because of its inherent advantages: technique can be initiated simply and quickly, no highly trained personnel nor expensive and complex apparatus are required and systemic anticoagulation is not needed.
Objectives: is to highlight the role of peritoneal dialysis in management of children with acute renal failure and to determined its complications.
Patients and methods: A retrospective study was carried out from 20th April 2012 till1st May 2014 ,on children with acute renal failure admitted to nephrology unit in Child Welfare Teaching Hospital and peritoneal dialysis was done for them in the acute intermittent peritoneal dialysis ward which was established since 2012 . Age ranged from one day up to fifteen years .Indications, complications of the procedure and outcome of recovery were recorded.
Results: Fifty nine children with acute renal failure were enrolled in the present study 23(39%) female and 36(61%) male, their age ranged from (8 days-15 years ). congenital malformations of renal system 13 (22%), hemolytic uremic syndrome 10(16.9%), sepsis 7(11.9%) were the predominant causes of acute renal failure. Complications of dialysis were significantly low among studied patients 18.6%(p<0.001).The main dialysis related complication was catheter malfunction(45%). The incidence of peritonitis 1(9%)(P=0.01).
Recovery of renal function after peritoneal dialysis found in 42 patients Survival rate among these patients was 97.6% (p<0.001) .Overall mortality was 22%. The most common cause of death was septicemia in (57%) of patients.
Conclusions: Because of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with ARF