U. Faller et al., Sonographic determination of the thickness of the peritoneum in healthy children and paediatric patients on CAPD, NEPH DIAL T, 13(12), 1998, pp. 3172-3177
Background. Prolonged peritoneal dialysis and frequent episodes of peritoni
tis lead to structural changes and thickening of the peritoneum. Ultrasonog
raphy investigations may provide the opportunity to detect morphological ch
anges early, but no systematic investigations have been performed yet.
Methods. Normal values of peritoneal thickness were obtained by systematica
lly examining 131 healthy children (0-15 years) by ultrasound. Parietal per
itoneal thickness was best measured at the sternal-umbical line distal from
the xiphoid. Growth charts with 95% intervals were prepared. The data of 2
6 patients with end-stage renal failure (5-18 years) were compared to those
of the normal children.
Results. The variation coefficient for the consecutive measurements was onl
y 5%, interobserver error was approximately 7%. Whereas gender did not have
any influence, peritoneal thickness was significantly correlated to age, w
eight and most obviously to height (r = 0.81; P < 0.001). Children treated
only by haemodialysis had normal values, while an increased thickness, loss
of movement, and adhesion of the two peritoneal layers were found in child
ren on CAPD. These changes were only noted in patients who had a history of
peritonitis.
Conclusion. Ultrasound examination is a simple, noninvasive and precise met
hod to measure the peritoneal changes in children on CAPD.