OXALATE ELIMINATION VIA HEMODIALYSIS OR PERITONEAL-DIALYSIS IN CHILDREN WITH CHRONIC-RENAL-FAILURE

Oxalate elimination and oxalate dialysance via hemodialysis (HD) or pe ritoneal dialysis (CAPD) has not been studied in detail in pediatric p atients. We studied plasma oxalate, oxalate elimination, and oxalate d ialysance in 15 infants and children undergoing CAPD (9 female, 6 male , aged 9 months to 18 years) and in 10 children on HD (4 female, 6 mal e, aged 7-18 years). Two children in each group had primary hyperoxalu ria (PH). The mean duration of dialysis prior to examination was 12 +/ - 11 months in CAPD and 31 +/- 23 months in HD patients. Bicarbonate H D was performed 5 h three times a week, CAPD consisted of five daily e xchanges in 5 patients and four changes in the remaining 10 children ( dwell volume 40 ml/kg body weight, 2.3 g/l glucose). Although oxalate dialysance was significantly higher in HD (mean 115.6 ml/min per 1.73 m(2) in HD versus 7.14 ml/min in CAPD), mean oxalate elimination per w eek was not different between both renal replacement therapies (3,478 mu mol/1.73 m(2) surface area/week in CAPD versus 3,915 mu mol/1.73 m( 2) per week in HD). Oxalate elimination in patients with PH was betwee n 6,650 and 9,900 mu mol/week. Plasma oxalate remained elevated in bot h procedures [28-84 mu mol/l in CAPD (92/148 in PH) and 33-101 mu mol/ l in HD (70/93 in PH)]. Oxalate elimination can be increased by a more frequent hemodialysis regimen.