The Factors Affecting The Efficiency of Continuous
Ambulatory Peritoneal Dialysis in Children

Cakar, Nilgun; OKDEMIR, DENIZ; sahin, irfan oguz

doi:10.5222/TP.2021.55264

The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children

Deniz Ökdemir, (Pediatrik Endokrinoloji Anabilim Dalı, Fırat Üniversitesi, Elazığ, Türkiye)

Nilgün Çakar, (Çocuk Nefrolojisi Anabilim Dalı, Ankara Üniversitesi, Ankara, Türkiye)

İrfan Oğuz Şahin (Ondokuz Mayıs Üniversitesi Çocuk Kardiyolojisi Anabilim Dalı, Samsun, Türkiye)

Trends in Pediatrics

1 0

Yıl: 2021 Cilt: 2 Sayı: 2 Sayfa Aralığı: 86 - 93 Metin Dili: İngilizce DOI: 10.5222/TP.2021.55264 İndeks Tarihi: 25-07-2022

The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children

Öz:

Objective: Peritoneal dialysis is a complex and variable process. Many factors can affect efficiency of dialysis, and relevant mortality and morbidity rates. Efficient dialysis is important in improving quality of life as well as reducing the morbidity and mortality rates. Dialysis fill volume, intraperitoneal pressure and ultrafiltration (UF) are important variables that determine dialysis efficiency. We aimed to investigate the factors affecting dialysis efficiency and to determine necessities to develop a more effective dialysis program. Methods: Sixteen continuous ambulatory peritoneal dialysis (CAPD) patients between the ages of 7 and 19 years who were followed up in the Pediatric Nephrology Department were included in the study. Patients who had peritonitis, surgical or medical complications in the last 6 months were excluded from the study. Demographic data, duration of dialysis, hemogram, urea, creatinine, albumin, glucose levels, intraperitoneal pressures, peritoneal equilibration test (PET) and Kt/Vurea test results were recorded. Results: Mean Kt /Vurea, dialysis fill volume, UF, intraperitoneal pressure, Hb and serum albumin were found as 2.5±0.93 (1.22- 4.64), 1123.4±126.86 (875-1360) ml/m2, 600.1±382.15 (85 -1375) ml, 12.9±2.77 (8.5-19) cm/H2O, 9.0±1.54 (6.3-11.8) gr/dl and 3.6±0.61 (2.45-4.8) gr/dl, respectively. A statistically significant relationship was shown between UF and Kt/Vurea (p=0.04). The mean duration of dialysis was 54±36 months. The majority of the cases had high (37.5%) and medium-high (31.25%) peritoneal permeability. High permeability was found to have a significant relationship with the duration of dialysis (p=0.04). Conclusion: Efficient peritoneal dialysis depends on preserved ultrafiltration. Therefore, the dialysate volume should be calculated according to the intraperitoneal pressure and dialysis should be adjusted according to the permeability properties of the peritoneal membrane.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Alexander SR. Peritoneal dialysis. In: Holiday MA, Barratt TM, Avner ED (eds). Pediatric Nephrology 3 rd edition. Williams and Wilkins, Baltimore 1994:1339- 53.
2. Oreopoulos DG. Chronic peritonela dialysis. Cllin Nephrol. 1978;9:165-73.
3. Hansson JH, Watnick S. Update on peritoneal dialysis: Core Curriculum 2016. Am J Kidney Dis. 2016;67:151- 64. https://doi.org/10.1053/j.ajkd.2015.06.031
4. Baş S. Periton diyalizinde enfeksiyonlar ve tedavileri. http://www.ndthd.org.tr/images/periton-diyalizinde enfeksiyonlar ve tedavileri.pdf, Erişim tarihi: 01.02. 2020.
5. Serdengeçti K. Renal replacement therapies. In. Registry of the Nephrology, Dialysis and Transplantation in Turkey, Registry 2004, Eds: Erek E, Serdengeçti K, Süleymanlar G. Published by the Turkish Society of Nephrology, İstanbul-2005:33-8
6. Faller B. Continius ambulatory peritoneal dialysis. Rev Prat. 1991;41:1080-4.
7. Diaz VP, Ballesteros SS, Garcia EH, et al. Intraperitoneal pressure in peritoneal dialysis. Nefrologia. 2017;37:579- 86. Epub 2017 Jul 22. https://doi.org/10.1016/j.nefroe.2017.11.002
8. Fischbach M, Terzic J, Laugel V, et al. Measurement of hydrostatic intraperitoneal pressure: a useful tool for the improvement of dialysis dose prescription. Pediatr Nephrol. 2003;18:976-80. https://doi.org/10.1007/s00467-003-1199-9
9. Al-Hwiesh A, Al-Mueilo S, Saeed I, Al-Muhanna FA. Intraperitoneal pressure and intra-abdominal pressure: are they the same? Perit Dial Int. 2011;31:315-9. https://doi.org/10.3747/pdi.2010.00057
10. Leypoldt JK. Evaluation of peritoneal membrane permeability. Adv Ren Replace Ther. 1995;2:265-73. https://doi.org/10.1016/S1073-4449(12)80060-4
11. Tzamaloukas AH, Raj DS, Onime A, et al. The prescription of peritoneal dialysis. Semin Dial. 2008;21:250- 7. https://doi.org/10.1111/j.1525-139X.2007.00412.x
12. Prasad N, Rangaswamy D, Patel M, et al. Long-term outcomes in children on chronic continuous ambulatory peritoneal dialysis: a retrospective cohort study from a developing country. Pediatr Nephrol. 2019;34:2389- 97. https://doi.org/10.1007/s00467-019-04311-w
13. Fischbach M, Warady BA. Peritoneal dialysis prescription in children; bedsides principles for optimal practice. Pediatr Nephrol. 2009;24:1633-42. https://doi.org/10.1007/s00467-008-0979-7
14. Burkart JM, Piraino B, Bargman J, et al. National Kidney Foundation KDOQI Clinical practice guidelines and clinical practice recommendations. 2006 updates. Peritoneal dialysis adequacy. Am J Kidney Dis. 2006;48 (Suppl. 1):S91-S175. https://doi.org/10.1053/j.ajkd.2006.05.016
15. Krediet RT. On behalf of the European Best Practice Guidelines work group for Peritoneal Dialysis. 7: Adequacy of peritoneal dialysis. Nephrol Dial Transplant 2005;20(Suppl. 9):ix24-ix27. https://doi.org/10.1093/ndt/gfi1121
16. Lo WK, Bargman JM, Burkart J, et al. ISPD guidelines/ recommendations. Guideline on targets for solute and fluid removal in adult patients on chronic peritoneal dialysis. Perit Dial Int. 2006;26:520-2. https://doi.org/10.1177/089686080602600502
17. Paniagua R, Amato D, Vonesh E, et al. Mexican Nephrology Collaborative Study Group. Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol. 2002;13:1307-20. https://doi.org/10.1681/ASN.V1351307
18. Lo WK, Ho YW, Li CS, et al. Effect of Kt/V on survival and clinical outcome in CAPD patients in a randomized prospective study. Kidney Int. 2003;64:649-56.
19. Fischbach M, Terzic J, Provot E, et al. Intraperitoneal pressure in children: fill-volume related and impacted by body mass index. Perit Dial Int. 2003;23:391-4.
20. Davis I, Cizman B, Mindt K, et al. Relationship between drain volume/fill volume ratio and clinical outcomes associated with overfill complaints in peritoneal dialysis patients. Perit Dial Int. 2011;31:148-53. https://doi.org/10.3747/pdi.2010.00012
21. Fischbach M, Terzic J, Menouer S, Haraldsson B. Optimal volume prescription for children on peritoneal dialysis. Perit Dial Int. 2000;20:603-6. https://doi.org/10.1177/089686080002000604
22. Imholz AL, Koomen GC, Struijk DG, Arisz L, Krediet RT. Effect of an increased intraperitoneal pressure on fluid and solute transport during CAPD. Kidney Int. 1993;44:1078-85. https://doi.org/10.1038/ki.1993.351
23. Warady BA, Alexander S, Hossli S, et al. The relationship between intraperitoneal volume and solute transport in pediatric patients. Pediatric Peritoneal Dialysis Study Consortium. J Am Soc Nephrol. 1995;5:1935-9 https://doi.org/10.1681/ASN.V5111935
24. Outerelo MC, Gouveia R, Teixeira e Costa F, Ramos A. Intraperitoneal pressure has a prognostic impact on peritoneal dialysis patients. Perit Dial Int. 2014;34:652-4. https://doi.org/10.3747/pdi.2012.00192
25. Harris KP, Keogh AM, Alderson L. Peritoneal dialysis fill volume: can the patient tell the difference? Perit Dial Int. 2001;21 Suppl 3:S144-7 https://doi.org/10.1177/089686080102103S24
26. Fischbach M, Terzic J, Becmeur F, et al. Relationship between intraperitoneal hydrostatic pressure and dialysate volume in children on PD. Adv Perit Dial. 1996;12:330-4.
27. Durand PY, Chanliau J, Gamberoni J, Hestin D, Kessler M. Routine measurement of hydrostatic intraperitoneal pressure. Adv Perit Dial. 1992;8:108-12.
28. De Jesús Ventura M, Amato D, Correa-Rotter R, et al. Relationship between fill volume, intraperitoneal pressure, body size, and subjective discomfort perception in CAPD patients. Mexican Nephrology Collaborative Study Group. Perit Dial Int. 2000;20:188- 93. https://doi.org/10.1177/089686080002000205
29. Daugirdas JT Blake PG. In: S. Bozfakıoğlu (ed). Diyaliz el kitabı. Güneş Kitabevi, Ankara, 2003:169-81.
30. Bouts AH, Davin JC, Groothoff JW, et al. Standard peritoneal permeability analysis in children. J Am Soc Nephrol. 2000;11:943-50. https://doi.org/10.1681/ASN.V115943
31. Fukatsu A, Komatsu Y, Senoh H, et al. Clinical benefits and tolerability of increased fill volumes in Japanese peritoneal dialysis patients. Perit Dial Int. 2001;21:455- 61. https://doi.org/10.1177/089686080102100505
32. Rousso S, Banh TM, Ackerman S, et al. Impact of fill volume on ultrafiltration with icodextrin in children on chronic peritoneal dialysis. Pediatr Nephrol. 2016;31:1673-9. Epub 2016 May 13. https://doi.org/10.1007/s00467-016-3398-1
33. Paniagua R, Ventura Mde J, Rodríguez E, et al. Impact of fill volume on peritoneal clearances and cytokine appearance in peritoneal dialysis. Perit Dial Int. 2004;24:156-62. https://doi.org/10.1177/089686080402400206
34. Fischbach M, Zaloszyc A, Schaefer B, Schmitt CP. Optimizing peritoneal dialysis prescription for volume control: the importance of varying dwell time and dwell volume. Pediatr Nephrol. 2014;29:1321-7. https://doi.org/10.1007/s00467-013-2573-x
35. Ponferrada LP, Van Stone JC. Peritoneal dialysis kinetics. Adv Ren Replace Ther. 1995;2:341-8. https://doi.org/10.1016/S1073-4449(12)80032-X
36. Atkinson MA, Neu AM, Fivush BA, Frankenfield DL. Disparate outcomes in pediatric peritoneal dialysis patients by gender/race in the End-Stage Renal Disease Clinical Performance Measures project. Pediatr Nephrol. 2008;23:1331-8. https://doi.org/10.1007/s00467-008-0832-z
37. Fadrowski JJ, Frankenfield D, Amaral S, et al. Children on long-term dialysis in the United States: findings from the 2005 ESRD clinical performance measures project. Am J Kidney Dis. 2007;50:958-66. https://doi.org/10.1053/j.ajkd.2007.09.003

APA	OKDEMIR D, Cakar N, sahin i (2021). The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. , 86 - 93. 10.5222/TP.2021.55264
Chicago	OKDEMIR DENIZ,Cakar Nilgun,sahin irfan oguz The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. (2021): 86 - 93. 10.5222/TP.2021.55264
MLA	OKDEMIR DENIZ,Cakar Nilgun,sahin irfan oguz The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. , 2021, ss.86 - 93. 10.5222/TP.2021.55264
AMA	OKDEMIR D,Cakar N,sahin i The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. . 2021; 86 - 93. 10.5222/TP.2021.55264
Vancouver	OKDEMIR D,Cakar N,sahin i The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. . 2021; 86 - 93. 10.5222/TP.2021.55264
IEEE	OKDEMIR D,Cakar N,sahin i "The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children." , ss.86 - 93, 2021. 10.5222/TP.2021.55264
ISNAD	OKDEMIR, DENIZ vd. "The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children". (2021), 86-93. https://doi.org/10.5222/TP.2021.55264

APA	OKDEMIR D, Cakar N, sahin i (2021). The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. Trends in Pediatrics, 2(2), 86 - 93. 10.5222/TP.2021.55264
Chicago	OKDEMIR DENIZ,Cakar Nilgun,sahin irfan oguz The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. Trends in Pediatrics 2, no.2 (2021): 86 - 93. 10.5222/TP.2021.55264
MLA	OKDEMIR DENIZ,Cakar Nilgun,sahin irfan oguz The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. Trends in Pediatrics, vol.2, no.2, 2021, ss.86 - 93. 10.5222/TP.2021.55264
AMA	OKDEMIR D,Cakar N,sahin i The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. Trends in Pediatrics. 2021; 2(2): 86 - 93. 10.5222/TP.2021.55264
Vancouver	OKDEMIR D,Cakar N,sahin i The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children. Trends in Pediatrics. 2021; 2(2): 86 - 93. 10.5222/TP.2021.55264
IEEE	OKDEMIR D,Cakar N,sahin i "The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children." Trends in Pediatrics, 2, ss.86 - 93, 2021. 10.5222/TP.2021.55264
ISNAD	OKDEMIR, DENIZ vd. "The Factors Affecting The Efficiency of Continuous Ambulatory Peritoneal Dialysis in Children". Trends in Pediatrics 2/2 (2021), 86-93. https://doi.org/10.5222/TP.2021.55264