Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

  • Cahyani Gita Ambarsari Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-0387-1031
  • Partini Pudjiastuti Trihono Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-2893-6049
  • Agustina Kadaristiana Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-0999-9741
  • Taralan Tambunan Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Lily Mushahar Department of Nephrology, Tuanku Ja'afar Hospital, Seremban, Negeri Sembilan, Malaysia https://orcid.org/0000-0002-3173-6497
  • Henny Adriani Puspitasari Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-2666-6671
  • Eka Laksmi Hidayati Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-2896-3645
  • Sudung Oloan Pardede Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
DOI: https://doi.org/10.13181/mji.v28i4.3807
Keywords: child, chronic kidney disease, continuous ambulatory peritoneal dialysis, peritonitis, survival
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Abstract

BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients' outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children.

METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed.

RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5).

CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

References

  1. Frishberg Y, Rinat C, Becker-Cohen R. Renal replacement therapy (dialysis and transplantation) in pediatric end-stage kidney disease. In: Brenner and Rector's The Kidney. 10th ed. Philadelphia: Elsevier; 2016. p. 2402-37.

  2. Li PK, Cheung WL, Lui SL, Blagg C, Cass A, Hooi LS, et al. Increasing home-based dialysis therapies to tackle dialysis burden around the world: a position statement on dialysis economics from the 2nd Congress of the International Society for Hemodialysis. Nephrology. 2011;16(1):53-6. https://doi.org/10.1111/j.1440-1797.2010.01418.x

  3. Li PK, Chow KM, Van de Luijtgaarden MW, Johnson DW, Jager KJ, Mehrotra R, et al. Changes in the worldwide epidemiology of peritoneal dialysis. Nat Rev Nephrol. 2017;13(2):90-103. https://doi.org/10.1038/nrneph.2016.181

  4. Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int. 2016;36(5):481-508. https://doi.org/10.3747/pdi.2016.00078

  5. Szeto CC, Li PK, Johnson DW, Bernardini J, Dong J, Figueiredo AE, et al. ISPD catheter-related infection recommendations: 2017 update. Int Soc Perit Dial. 2017;37(2):141-54. https://doi.org/10.3747/pdi.2016.00120

  6. Lan PG, Clayton PA, Johnson DW, McDonald SP, Borlace M, Badve SV, et al. Duration of hemodialysis following peritoneal dialysis cessation in Australia and New Zealand: proposal for a standardized definition of technique failure. Perit Dial Int. 2016;36(6):623-30. https://doi.org/10.3747/pdi.2015.00218

  7. United States Renal Data System (USRDS). ESRD among children, adolescents, and young adults. In: Annual Data Report. Michigan; 2018. p. 463-500.

  8. Fraser N, Hussain FK, Connell R, Shenoy MU. Chronic peritoneal dialysis in children. Int J Nephrol Renovasc Dis. 2015;8:125-37. https://doi.org/10.2147/IJNRD.S82419

  9. North American Pediatric Renal Trials and Collaborative Studies. 2011 Annual Dialysis Report [Internet]. Boston: NAPRTCS; 2011 [cited 2012 Aug 1]. Available from: https://web.emmes.com/study/ped/annlrept/annualrept2011.pdf.

  10. Choy AS, Li PK. Sustainability of the peritoneal dialysis-first policy in Hong Kong. Blood Purif. 2015;40(4):320-5. https://doi.org/10.1159/000441580

  11. Chuengsaman P, Kasemsup V. PD first policy: Thailand's response to the challenge of meeting the needs of patients with end-stage renal disease. Semin Nephrol. 2017;37(3):287-95. https://doi.org/10.1016/j.semnephrol.2017.02.008

  12. Afiatin, Khoe LC, Kristin E, Masytoh LS, Herlinawaty E, Werayingyong P, et al. Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia. PLoS One. 2017;12(5):e0177436. https://doi.org/10.1371/journal.pone.0177436

  13. Treerutkuarkul A. Thailand: health care for all, at a price. Bull World Heal Organ. 2010;88(2):84-5. https://doi.org/10.2471/BLT.10.010210

  14. Bavanandan S, Ahmad G, Teo AH, Chen L, Liu FX. Budget impact analysis of peritoneal dialysis versus conventional in-center hemodialysis in Malaysia. Value Heal Reg Issues. 2016;9:8-14. https://doi.org/10.1016/j.vhri.2015.06.003

  15. Borzych-Duzalka D, Aki TF, Azocar M, White C, Harvey E, Mir S, et al. Peritoneal dialysis access revision in children: causes, interventions, and outcomes. Clin J Am Soc Nephrol. 2017;12(1):105-12. https://doi.org/10.2215/CJN.05270516

  16. Imani PD, Carpenter JL, Bell CS, Brandt ML, Braun MC, Swartz SJ. Peritoneal dialysis catheter outcomes in infants initiating peritoneal dialysis for end-stage renal disease. BMC Nephrol. 2018;19:231. https://doi.org/10.1186/s12882-018-1015-1

  17. Schaefer F, Borzych-Duzalka D, Azocar M, Munarriz RL, Sever L, Aksu N, et al. Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: insights from the International Pediatric Peritoneal Dialysis Network Registry. Perit Dial Int. 2012;32(4):399-409. https://doi.org/10.3747/pdi.2012.00126

  18. Sethna CB, Bryant K, Munshi R, Warady BA, Richardson T, Lawlor J, et al. Risk factors for and outcomes of catheter-associated peritonitis in children: The SCOPE Collaborative. Clin J Am Soc Nephrol. 2016;11(9):1590-6. https://doi.org/10.2215/CJN.02540316

  19. Prasad N, Gulati S, Gupta A, Sharma RK, Kumar A, Kumar R, et al. Continuous peritoneal dialysis in children: a single-centre experience in a developing country. Pediatr Nephrol. 2006;21(3):403-7. https://doi.org/10.1007/s00467-005-2090-7

  20. Sezer S, Ozdemir FN, Akman B, Arat Z, Anaforoglu I, Haberal M. Predictors of serum albumin level in patients receiving continuous ambulatory peritoneal dialysis. Adv Perit Dial. 2001;17:210-4.

  21. Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, et al. Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int. 2012;32(Suppl 2):S32-86. https://doi.org/10.3747/pdi.2011.00091

  22. National Renal Registry (Malaysian Society of Nephrology). 24th Report of the Malaysian dialysis and transplant registry 2016 [Internet]. 2016 [cited 2019 May 31]. p. 166-75. Available from: https://www.msn.org.my/nrr/mdtr2016.jsp.

  23. Dong J, Chen Y. Impact of the bag exchange procedure on risk of peritonitis. Perit Dial Int. 2010;30(4):440-7. https://doi.org/10.3747/pdi.2009.00117

  24. Kolesnyk I, Dekker FW, Boeschoten EW, Krediet RT. Time-dependent reasons for peritoneal dialysis technique failure and mortality. Perit Dial Int. 2010;30(2):170-7. https://doi.org/10.3747/pdi.2008.00277

  25. Verrina E, Edefonti A, Gianoglio B, Rinaldi S, Sorino P, Zacchello G, et al. A multicenter experience on patient and technique survival in children on chronic dialysis. Pediatr Nephrol. 2004;19(1):82-90. https://doi.org/10.1007/s00467-003-1270-6

  26. The World Bank. GNI per capita, PPP (current international $) [Internet]. 2017 [cited 2019 May 31]. Available from: https://data.worldbank.org/indicator/NY.GNP.PCAP.PP.CD.

  27. Chesnaye NC, Schaefer F, Groothoff JW, Bonthuis M, Reusz G, Heaf JG, et al. Mortality risk in European children with end-stage renal disease on dialysis. Kidney Int. 2016;89(6):1355-62. https://doi.org/10.1016/j.kint.2016.02.016

  28. KDIGO. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:136-50.

Published
2019-12-13
How to Cite
1.
Ambarsari CG, Trihono PP, Kadaristiana A, Tambunan T, Mushahar L, Puspitasari HA, Hidayati EL, Pardede SO. Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country. Med J Indones [Internet]. 2019Dec.13 [cited 2024Apr.25];28(4):329-37. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/3807
Issue
Vol. 28 No. 4 (2019): December
Section
Clinical Research

Copyright (c) 2019 Cahyani Gita Ambarsari, Agustina Kadaristiana, Partini Pudjiastuti Trihono, Lily Mushahar

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