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Pediatric peritoneal dialysis

John Dotis, Antigoni Pavlaki, Nikoleta Printza, Stella Stabouli, Stamatia Antoniou, Chrysa Gkogka, Nikolaos Kontodimopoulos, Fotios Papachristou
BACKGROUND: Progressive chronic kidney disease (CKD), irrespective of the underlying etiology, affects the quality of life (QoL) of children due to the need for regular follow-up visits, a strict medication program and diet intake. METHODS: The Greek version of the KIDSCREEN-52 multidimensional questionnaire was used in children with CKD, renal transplantation (RT) and in a control group (CG) of healthy children. RESULTS: Fifty-five patients between 8 and 18 years, with CKD (n = 25), RT (n = 16) and with end-stage renal disease (ESRD) on peritoneal dialysis (PD) (n = 14) were included...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Janice Crespo-Salgado, V Matti Vehaskari, Tyrus Stewart, Michael Ferris, Qiang Zhang, Guangdi Wang, Eugene E Blanchard, Christopher M Taylor, Mahmoud Kallash, Larry A Greenbaum, Diego H Aviles
BACKGROUND: End-stage renal disease (ESRD) is associated with uremia and increased systemic inflammation. Alteration of the intestinal microbiota may facilitate translocation of endotoxins into the systemic circulation leading to inflammation. We hypothesized that children with ESRD have an altered intestinal microbiota and increased serum levels of bacterially derived uremic toxins. METHODS: Four groups of subjects were recruited: peritoneal dialysis (PD), hemodialysis (HD), post-kidney transplant and healthy controls...
2016: Microbiome
Nuran Cetın, Nadide M Sav, Duran Karabel, Ali Yildirim, Bilal Yıldız
PURPOSE: Cardiovascular diseases are the main causes of morbidity and mortality in children with end-stage renal disease and the relationships among several relevant potential biomarkers were investigated in pediatric peritoneal dialysis patients. METHODS: Serum homocysteine, von Willebrand factor (vWF), apolipoproteins A and B, lipoprotein-a, high sensitive-CRP, hemoglobin, phosphorus and parathyroid hormone (PTH) levels, systolic (SBP) and diastolic (DBP) blood pressure, carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured in 21 pediatric peritoneal dialysis patients and control subjects...
2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Daniella Levy Erez, Irit Krause, Amit Dagan, Roxana Cleper, Yafa Falush, Miriam Davidovits
Objective. Owing to a shortage of kidney donors in Israel, children with end-stage renal disease (ESRD) may stay on maintenance dialysis for a considerable time, placing them at a significant risk. The aim of this study was to understand the causes of mortality. Study Design. Clinical data were collected retrospectively from the files of children on chronic dialysis (>3 months) during the years 1995-2013 at a single pediatric medical center. Results. 110 patients were enrolled in the study. Mean age was 10...
2016: International Journal of Nephrology
Maria E Linnaus, Crystal S Langlais, Kevin N Johnson, David M Notrica
INTRODUCTION: Hypertrophic pyloric stenosis is a commonly encountered pediatric surgical issue. Initially treated with open surgical techniques, many pediatric surgeons have adopted the minimally invasive approach using laparoscopy. However, some concerns exist that the rate of incomplete pyloromyotomy is elevated in laparoscopy. We propose a new technique to assess the adequacy of laparoscopic pyloromyotomy. METHODS: Adequacy of laparoscopic pyloromyotomy was assessed by confirming that the top of the serosa on one side of the pylorus has adequate freedom to reach the bottom of the muscle on other side...
August 17, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Roberto Chimenz, Antonio Lacquaniti, Laura Colavita, Valeria Chirico, Claudia Fede, Michele Buemi, Carmelo Fede
BACKGROUND: Peritonitis, the most important limitation of peritoneal dialysis (PD), could be detected by biomarkers in dialysate effluent, representing a noninvasive method to indirectly assess the peritoneum status. The aim of our study was to test high mobility group box 1 (HMGB1) in PD patients, evaluating its role as precocious marker of peritoneum damage during peritonitis. Transforming growth factor (TGF)-β was correlated with peritoneal transport characteristics. METHODS: Six patients, treated by ambulatory PD, were enrolled...
August 8, 2016: Renal Failure
Ilan I Maizlin, Michelle C Shroyer, Lena Perger, Mike K Chen, Elizabeth A Beierle, Colin A Martin, Scott A Anderson, Vincent E Mortellaro, David A Rogers, Robert T Russell
BACKGROUND: Recent advances in renal replacement therapy (RRT) have brought about a proliferation of dialysis in neonates (<30 d). This study aimed to assess morbidity and mortality after RRT initiation in this population. METHODS: Retrospective chart review of all patients between 2006 and 2014 requiring RRT initiated in the first 30 d of life was performed. RESULTS: A total of 49 patients were identified, of which 39 were boys and 10 were girls...
July 2016: Journal of Surgical Research
Sujata Chakravarti, Yasir Al-Qaqaa, Meghan Faulkner, Puneet Bhatla, Michael Argilla, Michelle Ramirez
Fluid overload (FO) is a common complication for pediatric patients in the intensive care unit. When conventional therapy fails, hemodialysis or peritoneal dialysis is classically used for fluid removal. Unfortunately, these therapies are often associated with cardiovascular or respiratory instability. Ultrafiltration, using devices such as the Aquadex™ system (Baxter Healthcare, Deerfield, IL, USA), is an effective tool for fluid removal in adult patients with congestive heart failure. As compared to hemodialysis, ultrafiltration can be performed using smaller catheters, and the extracorporeal volume and minimal blood flow rates are lower...
June 15, 2016: Pediatric Reports
Antonio Méndez-Durán, Manuel Humberto Ignorosa-Luna, Gilberto Pérez-Aguilar, Francisco Jesús Rivera-Rodríguez, José Jesús González-Izquierdo, Javier Dávila-Torres
BACKGROUND: The IMSS performs systematically the data updating of patients with renal replacement therapy (RRT) by an electronic record management referred as: Census patients with Chronical Renal Failure (CIRC) which aims to meet the prevalence of patients with chronic renal failure and the behavior of RRTat the IMSS. METHODS: A retrospective study includes 212 secondary hospitals with dialysis programs, with both pediatric and adult patients. CIRC data obtained from January to December 2014, number and nominal bonds of peritoneal dialysis (PD) and hemodialysis (HD)...
September 2016: Revista Médica del Instituto Mexicano del Seguro Social
Om P Mishra, Avinash K Rai, Pradeep Srivastava, Khushaboo Pandey, Abhishek Abhinay, Rajniti Prasad, Rabindra N Mishra, Franz Schaefer
BACKGROUND: Urinary neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), and interleukin 18 (IL-18) were found to be useful for early detection of acute kidney injury (AKI). The objective of this study was to determine the predictive ability of biomarkers for mortality and variation in levels in relation to different stages of AKI, need for dialysis, etiologies, and with duration of hospital stay. METHODS: Urinary NGAL, NAG, and IL-18 levels were measured in 50 children with AKI and 30 age- and gender-matched healthy controls...
July 7, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Marcia C Riyuzo, Liciana V de A Silveira, Célia S Macedo, José R Fioretto
OBJECTIVE: To evaluate the prognosis factors of children with sepsis and acute kidney injury. METHODS: This was a retrospective study of children with sepsis and acute kidney injury that were admitted to the pediatric intensive care unit (PICU) of a tertiary hospital. A multivariate analysis was performed to compare risk factors for mortality. RESULTS: Seventy-seven children (47 males) were retrospectively studied, median age of 4 months. Mean length of hospital stay was 7...
July 2, 2016: Jornal de Pediatria
Christine B Sethna, Kristina Bryant, Raj Munshi, Bradley A Warady, Troy Richardson, John Lawlor, Jason G Newland, Alicia Neu
BACKGROUND AND OBJECTIVES: The Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative is a quality improvement initiative that aims to reduce peritoneal dialysis-associated infections in pediatric patients on chronic peritoneal dialysis. Our objectives were to determine whether provider compliance with peritoneal dialysis catheter care bundles was associated with lower risk for infection at the individual patient level and describe the epidemiology, risk factors, and outcomes for peritonitis in the Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Leyat Tal, Joseph R Angelo, Ayse Akcan-Arikan
Peritoneal dialysis (PD) is generally considered the preferred extracorporeal therapy for neonates with acute kidney injury (AKI). However, there are situations when PD is not suitable, such as in patients with previous abdominal surgery, hyperammonemia and significant ascites or anasarca. Additionally, with a need to start PD soon after catheter placement, there is increased risk of PD catheter leak and infection. Extracorporeal continuous renal replacement therapy (CRRT) is challenging in severely ill neonates as it requires obtaining adequately sized central venous access to accommodate adequate blood flow rates and also adaptation of a CRRT machine meant for older children and adults...
November 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Mattias Carlström, Carmen Cananau, Antonio Checa, Katarina Wide, Lisa Sartz, Anders Svensson, Craig E Wheelock, Susanne Westphal, Zivile Békássy, Peter Bárány, Jon O Lundberg, Sverker Hansson, Eddie Weitzberg, Rafael T Krmar
BACKGROUND & PURPOSE: Infants on chronic peritoneal dialysis (PD) have an increased risk of developing neurological morbidities; however, the underlying biological mechanisms are poorly understood. In this clinical study, we investigated whether PD-mediated impairment of nitric oxide (NO) bioavailability and signaling, in patients with persistently low systolic blood pressure (SBP), can explain the occurrence of cerebral ischemia. METHODS & RESULTS: Repeated blood pressure measurements, serial neuroimaging studies, and investigations of systemic nitrate and nitrite levels, as well as NO signaling, were performed in ten pediatric patients on PD...
August 31, 2016: Nitric Oxide: Biology and Chemistry
John Dotis, Pavlos Myserlis, Nikoleta Printza, Stella Stabouli, Chrysa Gkogka, Antigoni Pavlaki, Fotios Papachristou
Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months...
August 2016: Renal Failure
Biswanath Basu, Tapan Kumar Sinha Mahapatra, Birendranath Roy, Franz Schaefer
BACKGROUND: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with high patient morbidity and mortality. There is no consensus on the best RRT modality for pediatric AKI. METHODS: The efficacy and safety of continuous peritoneal dialysis (cPD) and daily intermittent hemodialysis (dHD) were compared in 136 children aged 1 month to 16 years requiring RRT for AKI. Mortality, risk factors and causes of death, 1-month and 3-month renal recovery rates, and technique-related complications were assessed...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Nicholas C Chesnaye, Franz Schaefer, Jaap W Groothoff, Marjolein Bonthuis, György Reusz, James G Heaf, Malcolm Lewis, Elisabeth Maurer, Dušan Paripović, Ilona Zagozdzon, Karlijn J van Stralen, Kitty J Jager
We aimed to describe survival in European pediatric dialysis patients and compare the differential mortality risk between patients starting on hemodialysis (HD) and peritoneal dialysis (PD). Data for 6473 patients under 19 years of age or younger were extracted from the European Society of Pediatric Nephrology, the European Renal Association, and European Dialysis and Transplant Association Registry for 36 countries for the years 2000 through 2013. Hazard ratios (HRs) were adjusted for age at start of dialysis, sex, primary renal disease, and country...
June 2016: Kidney International
Alicia M Neu, Troy Richardson, John Lawlor, Jayne Stuart, Jason Newland, Nancy McAfee, Bradley A Warady
The Standardizing Care to improve Outcomes in Pediatric End stage renal disease (SCOPE) Collaborative aims to reduce peritonitis rates in pediatric chronic peritoneal dialysis patients by increasing implementation of standardized care practices. To assess this, monthly care bundle compliance and annualized monthly peritonitis rates were evaluated from 24 SCOPE centers that were participating at collaborative launch and that provided peritonitis rates for the 13 months prior to launch. Changes in bundle compliance were assessed using either a logistic regression model or a generalized linear mixed model...
June 2016: Kidney International
Guillaume Deslandes, Matthieu Gregoire, Régis Bouquié, Aude Le Marec, Sophie Allard, Eric Dailly, Alain Pineau, Emma Allain-Launay, Pascale Jolliet, Gwenaëlle Roussey, Dominique Navas
♦ Objectives: Assess the stability of several antibiotics in peritoneal dialysis (PD) solutions under common conditions of use in pediatrics, particularly in automated PD. ♦ Methods: Amoxicillin, cefazolin, cefepime, ceftazidime, imipenem, cotrimoxazole, tobramycin, vancomycin, and the association of ceftazidime + vancomycin and ceftazidime+ tobramycin, were tested in 3 different PD solutions: bicarbonate/lactate solution with 2 glucose concentrations (Physioneal 1.36 and 3.86%; Baxter Healthcare Corporation, Deerfield, IL, USA) and an icodextrin-containing solution (Extraneal; Baxter Healthcare Corporation, Deerfield, IL, USA)...
May 4, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Cindy Richards
Pediatric patients with end stage renal disease (ESRD) are not as prevalent as adults with ESRD, but the numbers are increasing each year. Medical management is the same for pediatric patients as it is with adults with ESRD: hemodialysis, peritoneal dialysis, no therapy, or transplantation. Among most pediatric nephrology centers, the goal for patients is to achieve transplantation.
January 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
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