PERITONEAL DIALYSIS IN NEWBORNS AND INFANTS IN THE LAST 20 YEARS: SINGLE CENTER EXPERIENCE

• Published in: İstanbul Tıp Fakültesi dergisi = Journal of the Istanbul Faculty of Medicine Vol. 87; no. 2; p. 127
• Main Authors: Aksu, Bagdagul, Yildirim, Zeynep Yuruk, Bor, Meltem, Yasa, Beril, Bilgin, Leyla, Uygur, Nevin, Yilmaz, Alev
• Format: Journal Article
• Language: English
• Published: Istanbul University Press 01-06-2024
• Subjects: Care and treatment; Complications and side effects; Continuous ambulatory peritoneal dialysis; Infants (Newborn); Patient outcomes; Pediatric research; Peritoneal dialysis; Statistics; Turkey
• ISSN: 1305-6433
• DOI: 10.26650/IUITFD.1422363

Objective: To evaluate patients who underwent acute and chronic peritoneal dialysis (PD) under the age of one one in terms of etiology, complications, and prognosis over 20 years and to compare the results between the first and last 10 years of acute and chronic peritoneal dialysis. Material and Method: Seventy-four peritoneal dialysis patients under the age of one in the Division of Pediatric Nephrology and Neonatal Intensive Care Unit of our hospital between January 2002 and December 2023 were evaluated retrospectively. The patients were divided into two groups: patients admitted in the 2002-2013 period (Group I) and patients admitted in the 2013-2023 period (Group II). Patients in Group I and Group II were compared in terms of acute and chronic peritoneal dialysis etiology, complications, and prognosis. Result: Forty-four of the patients (60%) were newborns, and the remaining 30 were infants (40%). There were 39 patients in Group I and 35 patients in Group II. There was no difference between Group I and Group II for acute dialysis in terms of neonatal and infant diagnoses, infectious and non-infectious complications, and prognosis (p>0.05). There was no difference between Group I and Group II in terms of neonatal and infant diagnoses, infectious and non-infectious complications, and infant prognosis (p>0.05). There was no death in the newborns in Group II and patient survival was higher than in the newborns in Group I (p=0.019). Conclusion: Peritoneal dialysis is the most commonly used method for renal replacement therapy in children facing both acute and chronic renal failure. In the last decade, despite high-quality care in the neonatal care unit, positive technological developments and effective management of PD, the most common infectious complication was still peritonitis, and the non-infectious complication was dialysate leakage, as in the previous 10 years. Keywords: Newborn, infant, peritoneal dialysis Amac: Bir yas altinda akut ve kronik periton diyalizi (PD) uygulanan hastalari 20 yillik surecte etiyoloji, komplikasyon ve prognoz acisindan degerlendirmek ve akut ve kronik periton diyalizinin ilk ve son on yillik donemleri arasindaki sonuclari karsilastirmak. Gerec ve Yontem: Hastanemiz Cocuk Nefroloji ve Yenidogan Yogun Bakim Unitesi'nde Ocak 2002 ile Aralik 2023 tarihleri arasinda yatan bir yas alti 74 periton diyalizi hastasi retrospektif olarak degerlendirildi. Hastalar 2002-2013 doneminde basvuran hastalar (Grup I) ve 2013-2023 doneminde basvuran hastalar (Grup II) olmak uzere iki gruba ayrildi. Grup I ve Grup Il'deki hastalar akut ve kronik periton diyalizi hastaliginin etiyolojisi, komplikasyonlari ve prognozu acisindan karsilastirildi. Bulgular: Hastalarin 44'u (%60) yenidogan, geri kalan 30'u sutcocugu (%40) idi. Grup l'de 39 hasta, Grup Il'de ise 35 hasta vardi. Akut diyaliz icin Grup I ve Grup II arasinda yenidogan ve sutcocugu tanilari, enfeksiyoz ve enfeksiyoz olmayan komplikasyonlar ve prognoz acisindan fark yoktu (p>0,05). Kronik diyaliz icin Grup I ve Grup II arasinda yenidogan ve sutcocugu tanilari, enfeksiyoz ve enfeksiyoz olmayan komplikasyonlar ve sutcocugu prognozu acisindan fark yoktu (p>0,05). Grup Il'deki yenidoganlarda olum yoktu ve hasta sag kalimi Grup l'deki yenidoganlara gore daha yuksekti (p=0,019). Sonuc: Periton diyalizi, hem akut hem de kronik bobrek yetmezligi ile karsi karsiya olan cocuklarda renal replasman tedavisi icin en sik kullanilan yontemdir. Son on yilda, yenidogan bakim unitesindeki yuksek kaliteli bakima, olumlu teknolojik gelismelere ve PD'deki etkin yonetime ragmen, onceki 10 yilda oldugu gibi en sik gorulen enfeksiyoz komplikasyon hala peritonit, enfeksiyoz olmayan komplikasyon ise diyalizat kacagiydi. Anahtar Kelimeler: Yenidogan, sutcocugu, periton diyalizi