Mechanical complications of peritoneal dialysis in Tunisian children

##plugins.themes.academic_pro.article.sidebar##

Published Nov 18, 2023
Download
pdf
Vol. 101 No. 10 (2023): Tunis med oct 2023

##plugins.themes.academic_pro.article.main##

Manel Jellouli
Department of Pediatrics, Charles Nicolle Hospital, Tunis, Tunisia/ Faculty of Medicine of Tunis, University of Tunis el Manar, UTM, Immunopathology and Immunology of Renal Transplantation Research Unit LR03SP01
Abir Abdellatif
Faculty of Medicine of Tunis
Abir Boussetta
Department of Pediatrics, Charles Nicolle Hospital, Tunis, Tunisia/ Faculty of Medicine of Tunis, University of Tunis el Manar, UTM, Immunopathology and Immunology of Renal Transplantation Research Unit LR03SP01
Youssef Hlel
Department of Pediatric Surgery, Habib Thameur Hospital, Tunis, Tunisia
Aid Daib
Department of Pediatric Surgery, Habib Thameur Hospital, Tunis,Tunisia
Nejib Kaabar
Department of Pediatric Surgery, Habib Thameur Hospital, Tunis, Tunisia
Yousra Kerkeni
Department of Pediatric Surgery A, Béchir Hamza Children's Hospital, Tunis, Tunisia
Yasmine Houas
Department of Pediatric Surgery A, Béchir Hamza Children's Hospital, Tunis, Tunisia
Riadh Jouini
Department of Pediatric Surgery A, Béchir Hamza Children's Hospital, Tunis, Tunisia
Said Jlidi
Department of Pediatric Surgery B, Béchir Hamza Children's Hospital, Tunis, Tunisia
Tahar Gargah
Department of Pediatrics, Charles Nicolle Hospital, Tunis, Tunisia/ Faculty of Medicine of Tunis, University of Tunis el Manar, UTM, Immunopathology and Immunology of Renal Transplantation Research Unit LR03SP01
Bayen Maalej
Department of Pediatric Emergency and Intensive Care , Hédi Chaker Hospital, Sfax, Tunisia
Sondes Sahli
Department of Pediatric Surgery A, Béchir Hamza Children's Hospital, Tunis, Tunisia

Abstract

Background : Peritoneal dialysis (PD) is the method of choice for extra-renal replacement therapy (ERT) for children with end-stage renal disease (ESRD), because of its various advantages. However, it presents different infectious and non-infectious complications, causes of important morbidity and mortality.


Aim: To determine the mechanical complications of PD in our center and to identify  risk factors of their occurrence.


Methods : We retrospectively collected the records of 99 patients who were treated with PD within the past eleven years in the department of pediatrics of the University Hospital Charles Nicolle of Tunis. Analysis examining possible risque factors were performed using parametric and non-parametric tests.


Results : A total of 63 patients had mechanical complications with an incidence of peritoneal dialysis catheter revision of 1 procedure every 38 months. The causes were dominated by catheter migration (27.5%) and obstruction by fibrin or blood clotting (19.8%). A history of peritonitis (p=0.046) and the presence of comorbidity (p=0.008) were the two independent risk factors for catheter revision. Inguinal hernia was noted in six patients. No patient presented with a hydrothorax.  Seven patients presented an episode of hemoperitoneum.


Conclusion : Our results lead us to focus our efforts on preventing peritonitis and controlling morbidity. Prospective studies will enable us to confirm our results.

Keywords:

peritoneal dialysis, children, mechanical complications, peritoneal dialysis catheter

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Sethna CB, Bryant K, Munshi R, Warady BA, Richardson T, Lawlor J, et al. Risk Factors for and Outcomes of Catheter-Associated Peritonitis in Children: The SCOPE Collaborative. Clin J Am SocNephrol CJASN. 2016;11(9):1590‑6.
  2. Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, et al. Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update. Perit Dial Int J IntSocPerit Dial. 2012;32(2_suppl):32‑86.
  3. Kofteridis DP, Valachis A, Perakis K, Maraki S, Daphnis E, Samonis G. Peritoneal dialysis-associated peritonitis: clinical features and predictors of outcome. Int J Infect Dis IJID Off PublIntSoc Infect Dis. 2010;14(6):489-493.
  4. Sanderson KR, Warady BA. End-stage kidney disease in infancy: an educational review. PediatrNephrolBerl Ger. 2020;35(2):229‑40.
  5. Lee KO, Park SJ, Kim JH, Lee JS, Kim PK, Shin JI. Outcomes of peritonitis in children on peritoneal dialysis: a 25-year experience at Severance Hospital. Yonsei Med J. 2013;54(4):983‑9.
  6. Ambarsari CG, Trihono PP, Kadaristiana A, Tambunan T, Mushahar L, Puspitasari HA, et al. Five-year experience of continuous ambulatory peritoneal dialysis in children: A single center experience in a developing country. Med J Indones. déc 2019;28(4):329‑37.
  7. Li PKT, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD Peritonitis Recommendations: Update on Prevention and Treatment. Perit Dial Int. 2016;36(5):481‑508.
  8. Swartz SJ, Neu A, Skversky Mason A, Richardson T, Rodean J, Lawlor J, et al. Exit site and tunnel infections in children on chronic peritoneal dialysis: findings from the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative.PediatrNephrolBerl Ger. 2018;33(6):1029‑35.
  9. Borzych-Duzalka D, Aki TF, Azocar M, White C, Harvey E, Mir S, et al. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes. Clin J Am Soc NephrolCJASN;12(1):105‑12.
  10. Aksoy GK, Ekim M, Bakkaloğlu SA, Coşkun S, Delibaş A, Conkar S, et al. Evaluation of non-infectious complications of peritoneal dialysis in children: a multicenter study. PediatrNephrolBerl Ger. 2021;36(2):417‑23.
  11. Kim JE, Park SJ, Oh JY, Kim JH, Lee JS, Kim PK, et al. Noninfectious Complications of Peritoneal Dialysis in Korean Children: A 26-Year Single-Center Study. Yonsei Med J. 56(5):1359‑64.
  12. LaPlant MB, Saltzman DA, Segura BJ, Acton RD, Feltis BA, Hess DJ. Peritoneal dialysis catheter placement, outcomes and complications. PediatrSurg Int. 34(11):1239‑44.
  13. Carpenter JL, Fallon SC, Swartz SJ, Minifee PK, Cass DL, Nuchtern JG, et al. Outcomes after peritoneal dialysis catheter placement. J Pediatr Surg. 51(5):730‑3.
  14. Phan J, Stanford S, Zaritsky JJ, DeUgarte DA. Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters. J PediatrSurg. 48(1):197‑202.
  15. Ladd AP, Breckler FD, Novotny NM. Impact of primary omentectomy on longevity of peritoneal dialysis catheters in children. Am J Surg. 201(3):401‑4
  16. Stewart CL, Acker SN, Pyle LL, Kulungowski A, Cadnapaphornchai M, Bruny JL, et al. Factors associated with peritoneal dialysis catheter complications in children. J Pediatr Surg. 2016;51(1):159‑62.
  17. Cho MH. Infectious and Non-infectious Complications of Peritoneal Dialysis in Children. Child Kidney Dis. 2020;24(2):63‑8.
  18. Dufek S, Holtta T, Fischbach M, Ariceta G, Jankauskiene A, Cerkauskiene R, et al. Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis-A survey from the European Paediatric Dialysis Working Group. PediatrNephrolBerl Ger. 2015;30(11):2021‑7.
  19. Aksoy OY, Gulaldi NCM, Bayrakci US. Hydrothorax in a pediatric patient on peritoneal dialysis: Answers. PediatrNephrolBerlGer. 2020;35(8):1421‑3.
  20. Alhasan KA. Recurrent hydrothorax in a child on peritoneal dialysis: A case report and review of the literature. Clin Case Rep. 2019;7(1):149‑51.
  21. Ambarsari CG, Bermanshah EK, Putra MA, Rahman FHF, Pardede SO. Effective Management of Peritoneal Dialysis-Associated Hydrothorax in a Child: A Case Report. Case Rep Nephrol Dial. 2020;10(1):18‑25.
  22. Lim TSC, Thong KM. Resolution of pleura-peritoneal fistula via transient daytime ambulatory peritoneal dialysis regime (DAPD) - 8 years follow up. Pak J Med Sci. 2016;32(5):1302‑4.
  23. Lim CTS, Thong KM. Acute hydrothorax from peritoneal dialysis successfully treated with new dialysis regime -. Rawal Med J. 2015;40(4):463‑4.
  24. Frehat MQF, Al-Salaita GM, Al-Bderat JT, Alhadidi AM, Mohammad SA, Shaaban AM, et al. Chronic peritoneal dialysis in children: a single-centre experience in Jordan. Sudan J Paediatr. 2020;20(1):34‑41.
  25. Asi T, Düzova A, Doğan HS, Karakurt G, Bahadır ÖF, Bozacı AC, et al. Determinants of outcomes in chronic pediatric peritoneal dialysis: a single center experience. Turk J Pediatr. 2020;62(6):940.
  26. Ambarsari CG, Trihono PP, Kadaristiana A, Tambunan T, Mushahar L, Puspitasari HA, et al. Five-year experience of continuous ambulatory peritoneal dialysis in children: A single center experience in a developing country. Med J Indones. 2019;28(4):329‑37.
  27. Tiewsoh K, Soni A, Dawman L, Peters NJ, Malik MA. Chronic peritoneal dialysis in children with chronic kidney disease: An experience from a North Indian teaching institute. J Fam Med Prim Care. 2021;10(10):3682‑7.