LESSONS FROM THE PERITONEAL-DIALYSIS PATIENT DATABASE - A REPORT OF THE NORTH-AMERICAN PEDIATRIC RENAL-TRANSPLANT COOPERATIVE STUDY

Data derived from 1383 independent courses of peritoneal dialysis have been recorded in the database of the North American Pediatric Renal T ransplant Cooperative Study (NAPRTCS). Automated peritoneal dialysis ( APD) continues to be the preferred modality. Peritoneal access is most commonly achieved with a Tenckhoff curled catheter with a single-cuff and straight tunnel. Overall, the peritonitis rate is 1 infection eve ry 13.3 months, the frequency of infection being greatest in the young est patients. Two-cuffed catheters and exit-sites directed down positi vely influence this rate. Excessive infection is the primary reason fo r modality termination in surviving patients not transplanted. A total of 64 deaths have occurred in the peritoneal dialysis population. The 12-month and 24-month mortality probabilities in children < two years of age are significantly greater than comparable data in the older ch ildren.