Selection of modalities, prescription, and technical issues in children on peritoneal dialysis
Open Access
- 1 August 2009
- journal article
- review article
- Published by Springer Science and Business Media LLC in Pediatric Nephrology
- Vol. 24 (8), 1453-1464
- https://doi.org/10.1007/s00467-008-0848-4
Abstract
Peritoneal dialysis (PD) is widely employed as a dialytic therapy for uraemic children, especially in its automated form (APD), that is associated with less burden of care on patient and family than continuous ambulatory PD. Since APD offers a wide range of treatment options, based on intermittent and continuous regimens, prescription can be individualized according to patient’s age, body size, residual renal function, nutritional intake, and growth-related metabolic needs. Transport capacity of the peritoneal membrane of each individual patient should be assessed, and regularly monitored, by means of standardized peritoneal function tests validated in pediatric patients. To ensure maximum recruitment of peritoneal exchange area, fill volume should be scaled to body surface area and adapted to each patient, according to clinical tolerance and intraperitoneal pressure. PD solutions should be employed according to their biocompatibility and potential ultrafiltration capacity; new pH-neutral, glucose-free solutions can be used in an integrated way in separate dwells, or by appropriately mixing during the same dialytic session. Kinetic modelling software programs may help in the tailoring of PD prescription to individual patients’ characteristics and needs. Owing to advances in the technology of new APD machines, greater programming flexibility, memorized delivery control, and tele-dialysis are currently possible.Keywords
This publication has 81 references indexed in Scilit:
- Aseptic peritonitis due to peptidoglycan contamination of pharmacopoeia standard dialysis solutionThe Lancet, 2005
- Aseptic peritonitis due to peptidoglycan contamination of pharmacopoeia standard dialysis solutionThe Lancet, 2005
- Effect of peritoneal dialysis fluid composition on peritoneal area available for exchange in childrenNephrology Dialysis Transplantation, 2004
- A multicenter experience on patient and technique survival in children on chronic dialysisPediatric Nephrology, 2004
- Peritoneal dialysis: Changes to the structure of the peritoneal membrane and potential for biocompatible solutionsKidney International, 2003
- Glucose degradation products in peritoneal dialysis fluids: Do they harm?Kidney International, 2003
- The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patientsPediatric Nephrology, 2002
- Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal transport kinetics in childrenKidney International, 2002
- Assessing the peritoneal dialysis capacities of individual patientsKidney International, 1995
- Long-term effect of amino-acid dialysis solution in children on continuous ambulatory peritoneal dialysisPediatric Nephrology, 1991