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Open Access 01-09-2013 | Review

Clinical practice recommendations for the care of infants with stage 5 chronic kidney disease (CKD5)

Authors: Aleksandra M. Zurowska, Michel Fischbach, Alan R. Watson, Alberto Edefonti, Constantinos J. Stefanidis, on behalf of the European Paediatric Dialysis Working Group

Published in: Pediatric Nephrology | Issue 9/2013

Abstract

Background

To provide recommendations for the care of infants with stage 5 chronic kidney disease (CKD5).

Setting

European Paediatric Dialysis Working Group.

Data Sources

Literature on clinical studies involving infants with CKD5 (end stage renal failure) and consensus discussions within the group.

Recommendations

There has been an important change in attitudes towards offering RRT (renal replacement therapy) to both newborns and infants as data have accumulated on their improved survival and long-term outcomes. The management of this challenging group of patients differs in a number of ways from that of older children. The authors have summarised the basic recommendations for treating infants with CKD5 in order to support the multidisciplinary teams who endeavour on this difficult task.

van der Heijden B, Dijk P, Verrier-Jones K, Jager K, Briggs D (2004) Renal replacement therapy in children: data from 12 registries in Europe. Pediatr Nephrol 19:213–221PubMedCrossRef

Carey W, Talley L, Sehring S, Jaskula J, Mathias R (2007) Outcomes of dialysis initiated during the neonatal period for treatment of end-stage renal disease: a North American Pediatric Renal Trials and Collaborative Studies special analysis. Pediatrics 119:468–473CrossRef

van Stralen K, Tizard E, Verrina E, Schaefer F, Jager K (2010) Demographics of paediatric renal replacement therapy in Europe: 2007 annual report of the ESPN/ERA-EDTA registry European Society for Paediatric Nephrology/ European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) registry study group. Pediatr Nephrol 25:1379–1382PubMedCrossRef

Verrina E, Zacchello G, Perfumo F, Edefonti A, Sorino P, Bassi S, Andreetta B, Cattarelli D, Capasso G, Consalvo G (1995) Clinical experience in the treatment of infants with chronic peritoneal dialysis. Adv Perit Dial 11:281–284PubMed

Coulthard MG, Crosier J (2002) Outcome of reaching end stage renal failure in children under 2 years of age. Arch Dis Child 87:511–517PubMedCrossRef

Jander A, Nowicki M, Tkaczyk M, Makulska I, Zwolińska D, Latoszyńska J, Boguszewska-Baczkowska A, Grenda R, Bałasz-Chmielewska I, Zagozdzon I, Załuska-Leśniewska I, Zurowska A, Stefaniak E, Zachwieja J, Leszczyńska B, Roszkowska-Blaim M, Zachwieja K, Pietrzyk JA, Wierciński R, Zoch-Zwierz W, Stankiewicz R (2006) Chronic peritoneal dialysis in infants—preliminary results of a multicenter survey. Przegl Lek 63[Suppl 3]:72–74PubMed

Laakkonen H, Hölttä T, Lönnqvist T, Holmberg C, Rönnholm K (2008) Peritoneal dialysis in children under two years of age. Nephrol Dial Transplant 23:1747–1753PubMedCrossRef

Rheault M, Rajapal J, Chavers B, Nevins T (2009) Outcomes of infants < 28 days old treated with peritoneal dialysis for end-stage renal disease. Pediatr Nephrol 24:2035–2039PubMedCrossRef

Mekahli D, Shaw V, Ledermann SE, Rees L (2010) Long-term outcome of infants with severe chronic kidney disease. Clin J Am Soc Nephrol 5:10–17PubMedCrossRef

10.

Wedekin M, Ehrich JH, Offner G, Pape L (2010) Renal replacement therapy in infants with chronic renal failure in the first year of life. Clin J Am Soc Nephrol 5:18–23PubMedCrossRef

11.

Uhlig K, Macleod A, Craig J, Lau J, Levey AS, Levin A, MoistL SE, Walker R, Wanner C, Lameire N, Eknoyan G (2001) Grading evidence and recommendations for clinical practice guidelines in nephrology. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 70:2058–2065

12.

Wood E, Hand M, Briscoe D, Donaldson L, Yiu V, Harley F, Warady B, Ellis E (2001) Risk factors for mortality in infants and young children on dialysis. North American Pediatric Renal Transplant Cooperative Study. Am J Kidney Dis 37:573–579PubMedCrossRef

13.

Shroff R, Ledermann S (2009) Long-term outcome of chronic dialysis in children. Pediatr Nephrol 24:463–474PubMedCrossRef

14.

Vidal E, Edefonti A, Murer L, Gianoglio MS, Pecoraro C, Sorino P, Leozappa G, Lavoratti G, Ratsch I, Chimenz R, Verrina E (2012) Peritoneal dialysis in infants: the experience of the Italian Registry of Paediatric Chronic Dialysis Nephrol. Dial Transplant 27:388–395CrossRef

15.

Tong A, Lowe A, Sainsbury P, Craig JC (2010) Parental perspectives on caring for a child with chronic disease: an in-depth interview study. Child Care Health Dev 36:549–557PubMedCrossRef

16.

Rönnholm KA, Holmberg C (2006) Peritoneal dialysis in infants. Pediatr Nephrol 21:751–756PubMedCrossRef

17.

Beaunoyer M, Snehal M, Li L, Concepcion W, Salvatierra O Jr, Sarwal M (2007) Optimizing outcomes for neonatal ARPKD. Pediatr Transplant 11:267–271PubMedCrossRef

18.

Wühl E, Kogan J, Zurowska A, Matejas V, Vandevoorde R, Aigner T, Wendler O, Lesniewska I, Bouvier R, Reis A, Weis J, Cochat P, Zenker M (2007) Neurodevelopmental deficits in Pierson (microcoria-congenital nephrosis) syndrome. Am J Med Genet 143:311–319PubMedCrossRef

19.

Burguet A, Abraham-Lerat L, Cholley F, Champion G, Bouissou F, André J (2002) Terminal and pre-terminal chronic renal insufficiency in newborns in French neonatal intensive care units: survey of the French pediatric nephrologic society of resuscitation and emergency. Arch Pediatr 9:489–494PubMedCrossRef

20.

Fauriel I, Moutel G, Duchange N, Montuclard L, Moutard ML, Cochat P, Hervé C (2005) Decision making concerning life-sustaining treatment in paediatric nephrology: professionals’ experiences and values. Nephrol Dial Transplant 20:2746–2750PubMedCrossRef

21.

Shooter M, Watson AR (2000) The ethics of withholding and withdrawing therapy in infants. Pediatr Nephrol 14:347–351PubMedCrossRef

22.

Cohen C (1987) Ethical and legal considerations in the care of the infants with end stage renal disease where parents elect conservative therapy. Pediatr Nephrol 1:166–171PubMedCrossRef

23.

Broniszczak D, Ismail H, Nachulewicz P, Szymczak M, Drewniak T, Markiewicz-Kijewska M, Kowalski A, Jobs K, Smirska E, Rubik J, Skobejko-Włodarska L, Gastoł P, Mikołajczyk A, Kalicinski P (2010) Kidney transplantation in children with bladder augmentation or ileal conduit diversion. Eur J Pediatr Surg 20:5–10PubMedCrossRef

24.

Watson A, Gartland C (2001) Guidelines by an ad hoc European committee for elective chronic peritoneal dialysis in pediatric patients. Perit Dial Int 21:240–244PubMed

25.

Van Dyck M, Sidler S, Proesmans W (1998) Chronic renal failure in infants: effect of strict conservative treatment on growth. Eur J Ped 157:59–763CrossRef

26.

González C, Bitsori M, Tullus K (2007) Progression of chronic renal failure in children with dysplastic kidneys. Pediatr Nephrol 22:1014–1020CrossRef

27.

Ismaili K, Schurmans T, Wissing KM, Hall M, Van Aelst C, Janssen F (2001) Early prognostic factors of infants with chronic renal failure caused by renal dysplasia. Pediatr Nephrol 16:260–264PubMedCrossRef

28.

Van Biesen W, Vanholder R, Veys N, Lameire N (2002) Peritoneal dialysis in anuric patients: concerns and cautions. Semin Dial 15:305–310PubMedCrossRef

29.

Rees L (2009) Long-term outcome after renal transplantation in childhood. Pediatr Nephrol 24:475–484PubMedCrossRef

30.

Shroff R, Wright E, Ledermann S, Hutchisson C, Rees L (2003) Chronic hemodialysis in infants and children under 2 years of age. Pediatr Nephrol 18:378–383PubMed

31.

Paul A, Fraser N, Manoharan S, Williams AR, Shenoy M (2011) The challenge of maintaining dialysis lines in the under twos. J Pediatr Urol 7:48–51PubMedCrossRef

32.

Fischbach M, Edefonti A, Schröder C, Watson A, European Pediatric Dialysis Working Group (2005) Hemodialysis in children: general practical guidelines. Pediatr Nephrol 20:1054–66PubMedCrossRef

33.

Fischbach M, Stefanidis C, Watson A, European Pediatric Peritoneal Dialysis Working Group (2002) Guidelines on peritoneal dialysis prescription in children. Nephrol Dial Transplant 17:380–385PubMedCrossRef

34.

Nüsken E, Dittrich K, Carbon R, Dötsch J (2010) Considering laparoscopic salvage options—is pre-emptive omentectomy necessary in paediatric peritoneal patients? Klin Padiatr 222:252–254PubMedCrossRef

35.

Warchol S, Ziolkowska H, Roszkowska-Blaim M (2003) Exit-site infection in children on peritoneal dialysis: comparison of two types of peritoneal catheters. Perit Dial Int 23:169–173PubMed

36.

Sojo E, Grosman M, Monteverde M, Bailez M, Delgado N (2004) Fibrin glue is useful in preventing early dialysate leakage in children on chronic peritoneal dialysis. Perit Dial Int 24:186–190PubMed

37.

Alam S, Sheldon C (2008) Urological issues in pediatric renal transplantation. Curr Opin Urol 18:413–418PubMedCrossRef

38.

Nahas W, David-Neto E (2009) Strategies to treat children with end-stage renal dysfunction and severe lower urinary tract anomalies for receiving a kidney transplant. Pediatr Transplant 3:524–535CrossRef

39.

Fischbach M, Lahlou A, Eyer D, Desprez P, Geisert J (1996) Peritoneal dialysis prescription for neonates. Perit Dial Int 16S1:10–12

40.

Fischbach M, Terzic J, Laugel V, Escande B, Dangelser C, Helmstetter A (2003) Measurement of hydrostatic intraperitoneal pressure: a useful tool for the improvement of dialysis prescription. Pediatr Nephrol 18:976–980PubMedCrossRef

41.

Fischbach M, Terzic J, Menouer S, Haraldsson B (2000) Optimal volume prescription for children on peritoneal dialysis. Perit Dial Int 20:603–606PubMed

42.

Fischbach M, Haraldsson B, Helms P, Danner S, Laugel V, Terzic J (2003) The peritoneal membrane a dynamic dialysis membrane in children. Adv Perit Dial 19:265–268PubMed

43.

Fischbach M, Terzic J, Chauvé S, Laugel V, Muller A, Haraldsson B (2004) Effect of peritoneal dialysis fluid composition on peritoneal area available for exchange in children. Nephrol Dial Transplant 19:925–932PubMedCrossRef

44.

Schröder C (2004) Optimal peritoneal dialysis: choice of volume and solution. Nephrol Dial Transplant 19:782–784PubMedCrossRef

45.

Verrina E, Cappelli V, Perfumo F (2009) Selection of modalities, prescription, and technical issues in children on peritoneal dialysis. Pediatr Nephrol 24:1453–1464PubMedCrossRef

46.

Fischbach M, Warady B (2009) Peritoneal dialysis prescription in children: bedside principles for optimal practice. Pediatr Nephrol 24:1633–1642PubMedCrossRef

47.

Schmitt C, Borzych D, Nau B, Wühl E, Zurowska A, Schaefer F (2009) Dialytic phosphate removal: a modifiable measure of dialysis efficacy in automated peritoneal dialysis. Perit Dial Int 29:465–471PubMed

48.

Canepa A, Verrina E, Perfumo F (2008) Use of new peritoneal dialysis solutions in children. Kidney Int Suppl 108:S137–144PubMedCrossRef

49.

Schmitt CP, Bakkaloglu SA, Klaus G, Schröder C, Fischbach M (2011) Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group. Pediatr Nephrol 26:1137–1147PubMedCrossRef

50.

Haas S, Schmitt CP, Arbeiter K, Bonzel KE, Fischbach M, John U, Pieper AK, Schaub TP, Passlick-Deetjen J, Mehls O, Schaefer F (2003) Improved acidosis correction and recovery of mesothelial cell mass with neutral-pH bicarbonate dialysis solution among children undergoing automated peritoneal dialysis. J Am Soc Nephrol 14:2632–2638PubMedCrossRef

51.

Schmitt CP, von Heyl D, Rieger S, Arbeiter K, Bonzel K, Fischbach M, Misselwitz J, Pieper A, Schaefer F, Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS) (2007) Reduced systemic advanced glycation end products in children receiving peritoneal dialysis with low glucose degradation product content. Nephrol Dial Transplant 22:2038–2044PubMedCrossRef

52.

Borzych D, Rees L, Ha IS, Chua A, Valles PG, Lipka M, Zambrano P, Ahlenstiel T, Bakkaloglu SA, Spizzirri AP, Lopez L, Ozaltin F, Printza N, Hari P, Klaus G, Bak M, Vogel A, Ariceta G, Yap HK, Warady BA, Schaefer F, International Pediatric PD Network (IPPN) (2010) The bone and mineral disorder of children undergoing chronic peritoneal dialysis. Kidney Int 78:1295–304PubMedCrossRef

53.

Klaus G (2006) Prevention and treatment of renal osteodystrophy in children on chronic renal failure: European guidelines. Pediatr Nephrol 21:151–159PubMedCrossRef

54.

Michallat AC, Dheu C, Loichot C, Danner S, Fischbach M (2005) Long daytime exchange in children on continuous cycling peritoneal dialysis: preservation of drained volume because of icodextrin use. Adv Perit Dial 21:195–199PubMed

55.

Dart A, Feber J, Wong H, Filler G (2005) Icodextrin reabsorption varies with age in children on automated peritoneal dialysis. Pediatr Nephrol 20:683–685PubMedCrossRef

56.

Coleman JE, Edefonti A, Watson AR (2001) Guidelines by an ad hoc committee on the assessment of growth and nutritional status in children on chronic peritoneal dialysis. Perit Dial Int 21:323

57.

Rees L (2007) Long-term peritoneal dialysis in infants. Perit Dial Int 27[Suppl 2]:S180–184PubMed

58.

Rees L, Azocar M, Borzych D, Watson AR, Büscher A, Edefonti A, Bilge I, Askenazi D, Leozappa G, Gonzales C, van Hoeck K, Secker D, Zurowska A, Rönnholm K, Bouts AH, Stewart H, Ariceta G, Ranchin B, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (IPPN) registry (2011) Growth in very young children undergoing chronic peritoneal dialysis. J Am Soc Nephrol 12:2303–2312CrossRef

59.

Watson AR (2006) Gastrostomy feeding in children on chronic peritoneal dialysis. Perit Dial Int 26:41–42PubMed

60.

Sienna J, Saqan R, The J, Frieling M, Secker D, Cornelius V, Geary D (2010) Body size in children with chronic kidney disease after gastrostomy tube feeding. Pediatr Nephrol 25:2115–2121PubMedCrossRef

61.

Mencarelli F, Kiepe D, Leozappa G, Stringini G, Cappa M, Emma F (2009) Growth hormone treatment started in the first year of life in infants with chronic renal failure. Pediatr Nephrol 24:1039–1046PubMedCrossRef

62.

Santos F, Moreno ML, Neto A, Ariceta G, Vara J, Alonso A, Bueno A, Afonso AC, Correia AJ, Muley R, Barrios V, Gómez C, Argente J (2010) Improvement in growth after 1 year of growth hormone therapy in well-nourished infants with growth retardation secondary to chronic renal failure: results of a multicenter, controlled, randomized, open clinical trial. Clin J Am Soc Nephrol 5:1190–1197PubMedCrossRef

63.

Rees L, Shaw V (2007) Nutrition in children with CRF and on dialysis. Pediatr Nephrol 22:1689–1702 Erratum in. Pediatr Nephrol 23:1193CrossRef

64.

Paglialonga F, Edefonti A (2009) Nutrition assessment and management in children on peritoneal dialysis. Pediatr Nephrol 24:721–730PubMedCrossRef

65.

KDOQI Work Group (2009) KDOQI clinical practice guideline for nutrition in children with chronic kidney disease: 2008 update. Am J Kidney Dis 53:S11–S104

66.

Ledermann S, Spitz L, Moloney J, Rees L, Trompeter R (2002) Gastrostomy feeding in infants and children on peritoneal dialysis. Pediatr Nephrol 17:246–25PubMedCrossRef

67.

von Schnakenburg C, Feneberg R, Plank C, Zimmering M, Arbeiter K, Bald M, Fehrenbach H, Griebel M, Licht C, Konrad M, Timmermann K, Kemper M (2006) Percutaneous endoscopic gastrostomy in children on peritoneal dialysis. Perit Dial Int 26:69–77

68.

Quan A, Baum M (1996) Protein losses in children on continuous cycler peritoneal dialysis. Pediatr Nephrol 10:728–731PubMedCrossRef

69.

Shaw V, Coleman J (2003) Nutritional management of renal disease in childhood. Ann Nestle 61:21–31

70.

Shroff R, Rees L, Trompeter R, Hutchinson C, Ledermann S (2006) Long-term outcome of chronic dialysis in children. Pediatr Nephrol 21:257–264PubMedCrossRef

71.

Zurowska A, Feneberg R, Warady BA, Zimmering M, Monteverde M, Testa S, Calyskan S, Drozdz D, Salusky I, Kemper MJ, Ekim M, Verrina E, Misselwitz J, Schaefer F (2008) Gram-negative peritonitis in children undergoing long-term peritoneal dialysis. Am J Kidney Dis 51:455–462PubMedCrossRef

72.

Boehm M, Vecsei A, Aufricht C, Mueller T, Csaicsich D, Arbeiter K (2005) Risk factors for peritonitis in pediatric peritoneal dialysis: a single-center study. Pediatr Nephrol 20:1478–1483PubMedCrossRef

73.

Warady BA, Feneberg R, Verrina E, Flynn JT, Müller-Wiefel DE, Besbas N, Zurowska A, Aksu N, Fischbach M, Sojo E, Donmez O, Sever L, Sirin A, Alexander SR, Schaefer F (2007) Peritonitis in children who receive long-term peritoneal dialysis: a prospective evaluation of therapeutic guidelines. J Am Soc Nephrol 18:2172–2179PubMedCrossRef

74.

Li P, Szeto C, Piraino B, Bernardini J, Figueiredo A, Gupta A, Johnson D, Kuijper E, Lye W, Schaefer F, Struijk D (2010) Peritoneal dialysis related infections recommendations: 2010 update. Perit Dial Int 30:393–423PubMedCrossRef

75.

Neu AM, Warady BA, Lederman HM, Furth SL, Fivush BA (1998) Hypogammaglobulinemia in infants and young children maintained on peritoneal dialysis. Pediatric Dialysis Study Consortium. Perit Dial Int 18:440–443PubMed

76.

Warady B, Belden B (1999) Kohaut E (1999) Neurodevelopmental outcome of children initiating peritoneal dialysis in early infancy. Pediatr Nephrol 13:759–765PubMedCrossRef

77.

Madden S, Ledermann S, Guerrero-Blanco M, Bruce M, Trompeter R (2003) Cognitive and psychosocial outcome of infants dialysed in infancy. Child Care Health Dev 29:55–61PubMedCrossRef

78.

Neuhaus T (2004) Immunization in children with chronic renal failure: a practical approach. Pediatr Nephrol 19:1334–1339PubMedCrossRef

79.

Humar A, Arrazola L, Mauer M, Matas A, Najarian J (2001) Kidney transplantation in young children: should there be a minimum age. Pediatr Nephrol 16:941–945PubMedCrossRef

80.

Chavers B, Najarian J, Humar A (2007) Kidney transplantation in infants and small children. Pediatr Transpl 11:702–708CrossRef

81.

Kari J, Romagnoli J, Duffy P, Fernando O, Rees L, Trompeter R (1999) Renal transplantation in children under 5 years of age. Pediatr Nephrol 13(9):730–736PubMedCrossRef

82.

Moudgil A, Martz K, Stablein DM, Puliyanda D (2011) Good outcome of kidney transplants in recipients of young donors: a NAPRTCS data analysis. Pediatr Transplant 15:167–171PubMed

Title: Clinical practice recommendations for the care of infants with stage 5 chronic kidney disease (CKD5)
Authors: Aleksandra M. Zurowska
Michel Fischbach
Alan R. Watson
Alberto Edefonti
Constantinos J. Stefanidis
on behalf of the European Paediatric Dialysis Working Group
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 9/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-012-2300-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical practice recommendations for the care of infants with stage 5 chronic kidney disease (CKD5)

Abstract

Background

Setting

Data Sources

Recommendations

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Setting

Data Sources

Recommendations

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