INFECTIOUS AND CATHETER-RELATED COMPLICATIONS IN PEDIATRIC-PATIENTS TREATED WITH PERITONEAL-DIALYSIS AT A SINGLE INSTITUTION

Continuous ambulatory peritoneal dialysis (CAPD) and continuous cyclin g peritoneal dialysis (CCPD) are the predominant dialytic modalities f or the majority of children while awaiting transplantation. Wide accep tability of peritoneal dialysis is hindered by infectious complication s. A retrospective review of 367 pediatric patients treated with CAPD/ CCPD for at least 3 months from September 1980 through December 1994 r evealed that the peritonitis incidence ranged from 1.7 to 0.78 episode s per patient-year. No differences in peritonitis rates were observed between patients treated with CAPD or CCPD. Gram-positive organisms we re responsible for the majority of peritonitis episodes. Age, sex, rac e, primary renal disease, presence of nephrotic syndrome, and serum al bumin level were not associated risk factors. Longer time on treatment and diminished serum IgG level were associated with increased periton itis incidence. Treatment was successfully completed at home in most c ases. Almost half of the catheter losses were caused by Staphylococcus , Pseudomonas, and fungal peritonitis and tunnel/exit-site infections. Infectious complications are still the major causes of morbidity and treatment failure in patients treated with CAPD/CCPD. Thus, controlled studies are needed to assess methods for prevention or improvement of peritonitis rates in this patient population.