Clinical outcome of pediatric patients on peritoneal dialysis under adequacy control

Abstract 

Clinical outcome under adequacy control was studied in 10 pediatric patients under 5 years and 11 patients over 5 years of age on continuous peritoneal dialysis (PD). Outcome was compared between the age groups and with our previous results in patients under 5 years of age. Peritoneal equilibration test and 24-h dialysate collection were performed. Laboratory data, clinical status, and diet were recorded. PD prescription was adjusted for these parameters. The mean weekly urea Kt/V was similar and stable in the two age groups (3.1±0.6 vs. 3.2±0.4 at baseline). The mean weekly creatinine clearance (C _Cr) was at baseline significantly lower in the younger age group (58.7±11.9 vs. 78.0±14.9 l/week per 1.73 m², P=0.004), but later similar. Urea Kt/V and C _Cr correlated significantly. Hematological and biochemical parameters were stable, and catch-up growth was observed in 62% of the patients during 9 months of follow-up. The outcome for children under and over 5 years of age did not differ significantly. The clinical outcome in patients under 5 years of age improved under adequacy control, when compared with our previous results in patients of the same age. This suggests a positive effect of adequacy control on clinical outcome.