Outcomes of Maintenance Peritoneal Dialysis in Children: A State Hospital Experience from Southeastern Turkey

• Published in: Saudi journal of kidney diseases and transplantation Vol. 34; no. 1; pp. 51 - 60
• Main Authors: Kara, Mehtap Akbalik, Pinarbasi, Ayse Seda
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Medknow Publications and Media Pvt. Ltd 01-01-2023; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Albumins; Child; Child, Preschool; Children; Female; Health aspects; Hemodialysis; Hospitals, State; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Kidney Transplantation - adverse effects; Male; Mortality; Mupirocin; Patients; Pediatrics; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritonitis - etiology; Renal replacement therapy; Retrospective Studies; Risk Factors; Turkey - epidemiology; Turkey
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.391002

This study aimed to evaluate the clinical features, laboratory features, and outcomes of pediatric patients on peritoneal dialysis (PD) and compare the factors affecting mortality. The demographic, clinical, and laboratory data of 50 patients on maintenance PD followed up for more than 3 months were retrospectively analyzed for non-survivors and survivors to evaluate all factors affecting mortality. The patients (26 boys and 24 girls) had a mean age of 85.4 ± 58.7 months (range: 1-194 months) at the initiation of PD. The mean duration of dialysis at follow-up was 27.8 ± 21.7 months (range: 3-115 months). The rate of peritonitis was one episode per 27.27 patient months. PD was discontinued because of transplantation in eight patients, death in eight patients, and shifting to hemodialysis in three patients. In the Kaplan-Meier analysis, the 1-year patient survival rate at 1 year, 2 years, and 5 years was 81.8%, 51.7%, and 12.3%, respectively. Non-survivors were significantly younger at the start of kidney replacement therapy, had a final younger age at dialysis, and had lower albumin levels than survivors. We excluded four patients with a follow-up period of <6 months. Cox regression analysis revealed a low albumin status (P = 0.014, hazard ratio: 0.230) and a high level of ferritin (P = 0.002, hazard ratio: 1.002) to be risk factors for mortality. This study showed a high mortality rate. Hypoalbuminemia, a younger age at the start of kidney replacement therapy, and a younger final age at dialysis had a significant association with mortality.