INITIAL HYPOALBUMINEMIA AND HYPERLIPIDEMIA PERSIST DURING CHRONIC PERITONEAL-DIALYSIS IN CHILDREN

Objective: To document serum lipid values in pediatric peritoneal dial ysis (PD) patients, particularly the very young, and investigate relat ionships with serum albumin levels. Design: Retrospective review of al l PD patients seen in the first 11 years of the PD program at our inst itution. Patients and Methods: Any pediatric PD patient was eligible f or inclusion if at least four simultaneous measurements of serum lipid s and albumin were recorded over a minimum of 90 days of PD. Results:T hirty-nine continuous ambulatory peritoneal dialysis (CAPD) patients ( 9, aged <5 years) and 14 continuous cycling peritoneal dialysis (CCPD) patients (7, aged <5 years) were followed for 90-1200 days. Hypoalbum inemia, present in 43% of initial recordings, did not alter significan tly during PD in any group; it was most marked in the CAPD <5 year (me an 30.7 g/L) and CCPD >5 year groups (mean 31.4 g/L). Average serum ch olesterol levels were 27% higher, and triglyceride 122% higher, than t he maximum accepted 18-year-old level and did not change significantly during PD. Similarly, 33% of high-density lipid recordings were below normal and remained unaltered during PD. Conclusions: Our results con firm the high incidence of hypoalbuminemia, hypertriglyceridemia, and hypercholesterolemia and associated low levels of high-density lipids, even in young PD patients, and demonstrate that these remain unchange d during PD. Such results have not previously been reported in PD pati ents as young as ours. Abnormal lipid profiles area neglected cardiova scular risk factor in children with renal failure; therapeutic interve ntions should therefore be seriously considered.