DAILY PERITONEAL-DIALYSIS USING A SURGICALLY PLACED TENCKHOFF CATHETER FOR ACUTE-RENAL-FAILURE IN CHILDREN

Thirty-one infants and children with acute renal failure were treated with peritoneal dialysis using a surgically placed Tenckhoff catheter. In IO patients a peritoneal dialysis cycler was used, and 21 were dia lyzed by the manual method. initially, hourly exchanges were given for 24 to 48 h and, as the patients stabilized, 10 exchanges per day at I -h intervals were given. The mean stabilization period was 36 +/- 8 h. The predialysis mean serum creatinine was 5.8 +/- 1.8 mg% and the ser um creatinine while on daily dialysis was 2.8 +/- 1.1 mg%. Peritoneal dialysis succeeded in controlling metabolic abnormalities and improvin g fluid balance. All the catheters except one functioned immediately f ollowing insertion. Median duration of catheter placement for dialysis was 18 days (range 2 to 90). The incidence of peritonitis was 12.8%, and exit site infection was 6.4%. The infection rate was decreased whe n a cycler was used compared with the manual method (23.8% vs. 10.0%), though not statistically significant. Two patients developed hypother mia while being dialyzed via the manual method. To conclude, 10 daily peritoneal dialysis exchanges performed at 1-h intervals after initial stabilization using a surgically placed Tenckhoff catheter is an effe ctive and safe mode of dialytic therapy for children with acute renal failure. Complications (infection and hypothermia) are reduced with th e use of a cycler.