Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Pediatric Nephrology
Published in: Pediatric Nephrology 8/2009

Open Access 01-08-2009 | Educational Review

Selection of modalities, prescription, and technical issues in children on peritoneal dialysis

Authors: Enrico Verrina, Valeria Cappelli, Francesco Perfumo

Published in: Pediatric Nephrology | Issue 8/2009

Login to get access

Abstract

Peritoneal dialysis (PD) is widely employed as a dialytic therapy for uraemic children, especially in its automated form (APD), that is associated with less burden of care on patient and family than continuous ambulatory PD. Since APD offers a wide range of treatment options, based on intermittent and continuous regimens, prescription can be individualized according to patient’s age, body size, residual renal function, nutritional intake, and growth-related metabolic needs. Transport capacity of the peritoneal membrane of each individual patient should be assessed, and regularly monitored, by means of standardized peritoneal function tests validated in pediatric patients. To ensure maximum recruitment of peritoneal exchange area, fill volume should be scaled to body surface area and adapted to each patient, according to clinical tolerance and intraperitoneal pressure. PD solutions should be employed according to their biocompatibility and potential ultrafiltration capacity; new pH-neutral, glucose-free solutions can be used in an integrated way in separate dwells, or by appropriately mixing during the same dialytic session. Kinetic modelling software programs may help in the tailoring of PD prescription to individual patients’ characteristics and needs. Owing to advances in the technology of new APD machines, greater programming flexibility, memorized delivery control, and tele-dialysis are currently possible.
Appendix
Available only for authorised users
Literature
1.
Hattori S, Yosioka K, Honda M, Ito H (2002) The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol 17:456–461PubMed
2.
Verrina E, Edefonti A, Gianoglio B, Rinaldi S, Sorino P, Zacchello G, Lavoratti G, Maringhini S, Pecoraro C, Calevo MG, Turrini Dertenois L, Perfumo F (2004) A multicenter experience on patient and technique survival in children on chronic dialysis. Pediatr Nephrol 19:82–90PubMed
3.
Fadrowki JJ, Frankenfield D, Amaral S, Brady T, Gorman GH, Warady B, Furth SL, Fivush B, Neu AM (2007) Children on long-term dialysis in the United States: findings from the 2005 ESRD Clinical Performance Measures Project. Am J Kidney Dis 50:958–966
4.
Fischbach M, Stefanidis CJ, Watson AR (2002) Guidelines by an ad hoc European committee on adequacy of the pediatric peritoneal dialysis prescription. Nephrol Dial Transplant 17:380–385PubMed
5.
Morgestern B (2004) Peritoneal dialysis and prescription monitoring. In: Warady BA, Schaefer FS, Fine RN, Alexander SR (eds) Pediatric dialysis. Kluwer Academic Publishers, Dordrecht, p 147−161
6.
Geary DF, Harvey EA, MacMillan JH, Goodman Y, Scott M, Balfe JW (1992) The peritoneal equilibration test in children. Kidney Int 42:102−105PubMed
7.
Kohaut EC, Waldo FB, Benfield MR (1994) The effect of changes in dialysate volume on glucose and urea equilibration. Perit Dial Int 14:236−239PubMed
8.
Warady BA, Alexander SR, Hossli S, Vonesh E, Geary D, Kohaut EC (1995) The relationship between intraperitoneal volume and solute transport in pediatric patients. J Am Soc Nephrol 5:1935−1939PubMed
9.
Verrina E, Amici G, Perfumo F, Trivelli A, Canepa A, Gusmano R (1998) The use of the PD Adequest mathematical model in pediatric patients on chronic peritoneal dialysis. Perit Dial Int 18:322−328PubMed
10.
Warady BA, Alexander SR, Hossli S, Vonesh E, Geary D, Watkins S, Salusky IB, Kohaut EC (1996) Peritoneal membrane transport function in children receiving long-term dialysis. J Am Soc Nephrol 7:2385–2391PubMed
11.
Twardowski ZJ, Nolph KD, Khanna R, Prowant BF, Ryan LP, Moore HL (1987) Peritoneal equilibration test. Perit Dial Bull 7:138–147
12.
Schaefer F, Langebeck D, Heckert KH, Scharer K, Mehls O (1992) Evaluation of peritoneal solute transfer by the peritoneal equilibration test in children. Adv Perit Dial 8:410–415PubMed
13.
National Kidney Foundation (2006) KDOQI clinical practice recommendations for 2006 updates: hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Am J Kidney Dis 48 [Suppl 1]:S1–S322
14.
Schaefer F, Klaus G, Mehls O, Mid-European Pediatric Peritoneal Dialysis Study Group (1999) Peritoneal transport properties and dialysis dose affect growth and nutritional status in children on chronic peritoneal dialysis. J Am Soc Nephrol 10:1786–1792
15.
Zialkowska H, Paczyk-Tomaszweska M, Debiaski A, Sawicki A, Roszkowska-Blaim M (2003) Bone metabolism and peritoneal membrane transport in children on chronic peritoneal dialysis. Perit Dial Int 23:487–492
16.
Pride ET, Gustafson J, Graham A, Spoinhour L, Mauck V, Brown P, Burkart JM (2002) Comparison of a 2.5% and a 4.25% dextrose peritoneal equilibration test. Perit Dial Int 22:365–370PubMed
17.
Warady BA, Jennings J (2007) The short PET in pediatrics. Perit Dial Int 27:441–445PubMed
18.
Schaefer F (2007) The PET-iatrics of peritoneal solute transport: is short also good for the young ones? Perit Dial Int 27:413–414PubMed
19.
Reddingius RE, Schröder CH, Willems JL, Lelivelt M, Kohler BEM, Krediet RT, Monnens LAH (1995) Measurement of peritoneal fluid handling in children on continuous ambulatory peritoneal dialysis using dextran 70. Nephrol Dial Transplant 10:866–870PubMed
20.
Bouts AHM, Davin JC, Groothoff JW, Ploos van Amstel S, Zweers MM, Krediet RT (2000) Standard peritoneal permeability analysis in children. J Am Soc Nephrol 11:943–950PubMed
21.
Haraldsson B (1995) Assessing the individual peritoneal dialysis capacities of individual patients. A clinical tool based on the three-pore model. Kidney Int 47:1187–1198PubMed
22.
Schaefer F, Haraldsson B, Haas S, Simkova E, Feber J, Mehls O (1998) Estimation of peritoneal mass transport by three-pore model in children. Kidney Int 54:1372–1379PubMed
23.
Fischbach M, Haraldsson B (2001) Dynamic changes of total pore area available for peritoneal exchange in children. J Am Soc Nephrol 12:1524–1529PubMed
24.
Krediet RT, Lindholm B, Rippe B (2000) Pathophysiology of peritoneal membrane failure. Perit Dial Int 20 [Suppl 4]:S22–S42PubMed
25.
Williams JD, Craig KJ, Topley N, Williams GT (2003) Peritoneal dialysis: changes to the structure of the peritoneal membrane and potential for biocompatible solutions. Kidney Int 63 [Suppl 84]:S158–S161
26.
Witoski J, Jorres A, Korybalska K, Ksiazek K, Wisniewska-Elnur J, Bender TO, Passlick-Deetjen J, Breborowicz A (2003) Glucose degradation products in peritoneal dialysis fluids: do they harm? Kidney Int 63 [Suppl 84]:S148–S151
27.
Holmes CJ, Shockley TR (2000) Strategies to reduce glucose exposure in peritoneal dialysis. Perit Dial Int 20:S37–S41PubMed
28.
Sitter T, Sauter M (2005) Impact of glucose in peritoneal dialysis: saint or sinner. Perit Dial Int 25:415–425PubMed
29.
Williams JD, Topley N, Craig KJ, Mackenzie RK, Pischetsrieder M, Lage C, Passlick-Deetjen J (2004) The Euro-Balance Trial: the effect of a new biocompatible peritoneal dialysis fluid (Balance) on the peritoneal membrane. Kidney Int 66:408–418PubMed
30.
Schmitt CP, von Heyl D, Rieger S, Arbeiter K, Bonzel KE, Fischbach M, Misselwitz J, Pieper AK, Schaefer F (2007) Reduced systemic advanced glycation end products in children receiving peritoneal dialysis with low glucose degradation product content. Nephrol Dial Transplant 22:2038–2044PubMed
31.
Schröder CH (2001) The choice of dialysis solutions in pediatric chronic peritoneal dialysis: guidelines by an ad hoc European Committee. Perit Dial Int 21:568–574PubMed
32.
Posthuma N, ter Wee PM, Donker AJM, Oe PL, Peers EM, Verbrugh HA (2000) Assessment of the effectiveness, safety, and biocompatibility of icodextrin in automated peritoneal dialysis. Perit Dial Int 20 [Suppl 2]:S106–S113PubMed
33.
De Boer AW, Schröder CH, Van Vliet R, Willems JL, Monnens LAH (2000) Clinical experience with icodextrin in children: ultrafiltration profiles and metabolism. Pediatr Nephrol 15:21–24PubMed
34.
Verrina E, Amici G, Perfumo F, Trivelli A (2001) Evaluation of icodextrin absorption and ultrafiltration (UF) curve over a long day dwell in children on continuous cycling peritoneal dialysis. Perit Dial Int 21 [Suppl 1]:S93
35.
van Hoeck KJ, Rusthoven E, Vermeylen L, Vandesompel A, Marescau B, Lilien M, Schroder CH (2003) Nutritional effects of increasing dialysis dose by adding an icodextrin daytime dwell to nocturnal intermittent peritoneal dialysis (NIPD) in children. Nephrol Dial Transplant 18:1383–1387PubMed
36.
Rusthoven E, van der Vlugt ME, van Lingen-van Bueren LJ, van Schaijk TCJG, Willems HL, Monnens LAH, Schroeder CH (2005) Evaluation of intraperitoneal pressure and the effect of different osmotic agents on intraperitoneal pressure in children. Perit Dial Int 25:352–356PubMed
37.
Rusthoven E, Krediet RT, Willems HL, Monnens LA, Schröder CH (2005) Sodium sieving in children. Perit Dial Int 25 [Suppl 3]:S141–S142PubMed
38.
Martis L, Patel M, Giertych J, Mongoven J, Taminne M, Perrier MA, Mendoza O, Goud N, Costigan A, Denjoy N, Verger C, Owen WF Jr (2005) Aseptic peritonitis due to peptidoglycan contamination of pharmacopoeia standard dialysis solution. Lancet 365:588–594PubMed
39.
Cooker LA, Holmes CJ, Hoff CM (2002) Biocompatibility of icodextrin. Kidney Int 62 [Suppl 81]:S34–S45
40.
Gotloib L, Wajsbrot V, Shostak A (2005) Osmotic agents hamper mesothelial repopulation as seen in the doughnut in vivo model. Perit Dial Int 25 [Suppl 3]:S26–S30PubMed
41.
Freida P, Galach M, Divino Filho JC, Werynski A, Lindholm B (2007) Combination of crystalloid (glucose) and colloid (icodextrin) osmotic agents markedly enhances peritoneal fluid and solute transport during the long PD dwell. Perit Dial Int 27:267–276PubMed
42.
Jenkins SB, Wilkie ME (2003) An exploratory study of a novel peritoneal combination dialysate (1.36% glucose/7.5% icodextrin), demonstrating improved ultrafiltration compared to either component studied alone. Perit Dial Int 23:475–480PubMed
43.
Canepa A, Perfumo F, Carrea A, Giallongo F, Verrina E, Cantalupi A, Gusmano R (1991) Long-term effect of amino-acid dialysis solution in children on continuous ambulatory peritoneal dialysis. Pediatr Nephrol 5:215–219PubMed
44.
Canepa A, Carrea A, Menoni S, Verrina E, Trivelli A, Gusmano R, Perfumo F (2001) Acute effects of simultaneous intraperitoneal infusion of glucose and amino acids. Kidney Int 59:1967–1973PubMed
45.
Canepa A, Verrina E, Perfumo F, Carrea A, Menoni S, Delucchi P, Gusmano R (1999) Value of intraperitoneal amino acids in children treated with chronic peritoneal dialysis. Perit Dial Int 19 [Suppl 2]:S435–S440PubMed
46.
Garibotto G, Sofia A, Canepa A, Saffioti S, Sacco P, Sala MR, Dertenois L, Pastorino N, Deferrari G, Russo R (2001) Acute effects of peritoneal dialysis with dialysate containing dextrose or dextrose and amino acids on muscle protein turnover in patients on chronic renal failure. J Am Soc Nephrol 12:557–567PubMed
47.
Olszowska A, Wanieski J, Werynski A, Anderstam B, Lindholm B, Wankowicz Z (2007) Peritoneal transport in peritoneal dialysis patients using glucose-based and amino acid-based solutions. Perit Dial Int 27:544–553PubMed
48.
Witowski J, Jorres A (2005) Effects of peritoneal dialysis solutions on the peritoneal membrane: clinical consequences. Perit Dial Int 25 [Suppl 3]:S31–S33PubMed
49.
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 cells mass with neutral-pH bicarbonate dialysis solution among children undergoing automated peritoneal dialysis. J Am Soc Nephrol 14:2632–2638PubMed
50.
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 19:925–932PubMed
51.
Schmitt CP, Haraldsson B, Doetschmann R, Zimmering M, Greiner C, Böswald M, Klaus G, Passlick-Deetjen J, Schaefer F (2002) Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal transport in children. Kidney Int 61:1527–1536PubMed
52.
Fischbach M, Dheu C, Seuge-Dargnies L, Delobbe JF (2007) Adequacy of peritoneal dialysis in children: consider the membrane for optimal prescription. Perit Dial Int 27 [Suppl 2]:S167–S170PubMed
53.
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 dose prescription. Pediatr Nephrol 18:967–980
54.
Fischbach M, Lahlou A, Eyer D, Desprez P, Geisert J (1996) Determination of individual ultrafiltration time (APEX) and purification phosphate time by peritoneal equilibration test: application to individual peritoneal dialysis modality prescription in children. Perit Dial Int 16 [Suppl 1]:S557–S560PubMed
55.
Verrina E, Perfumo F (2004) Technical aspects of the peritoneal dialysis procedure. In: Warady BA, Schaefer FS, Fine RN, Alexander SR (eds) Pediatric dialysis. Kluwer Academic Publishers, Dordrecht, pp 113–134
56.
Edefonti A, Consalvo G, Picca M, Giani M, Damiani B, Ghio L, Galato R (1995) Dialysis delivery in children in nightly intermittent and tidal peritoneal dialysis. Pediatr Nephrol 9:329–332PubMed
57.
Hölltä T, Rönnholm K, Holmerg C (2000) Adequacy of dialysis with tidal and continuous cycling peritoneal dialysis in children. Nephrol Dial Transplant 15:1438–1442
58.
Amici G (1999) Continuous tidal peritoneal dialysis. Prescription and power. In: Ronco C, Amici G, Feriani M, Virga G (eds) Automated peritoneal dialysis. Karger, Basel, pp 134–141
59.
Brandes JC, Packard WJ, Watters SK, Fritsche C (1998) Optimization of dialysate flow and mass transfer during automated peritoneal dialysis. Am J Kidney Dis 25:603–610
60.
Freida P, Issad B (1999) Continuous cyclic peritoneal dialysis prescription and power. In: Ronco C, Amici G, Feriani M, Virga G (eds) Automated peritoneal dialysis. Karger, Basel, pp 99–108
61.
Vonesh EF (1999) Membrane transport models and computerized kinetic modeling applied to automated peritoneal dialysis. In: Ronco C, Amici G, Feriani M, Virga G (eds) Automated peritoneal dialysis. Karger, Basel, pp 15–34
62.
Warady BA, Watkins SL, Fivush BA, Andreoli SP, Salusky I, Kohaut EC, Vonesh EF (2001) Validation of PD Adequest 2.0 for pediatric dialysis patients. Pediatr Nephrol 16:205–211PubMed
63.
Ho-dac-Pannekeet MM, Atasever B, Strujik DG, Krediet RT (1997) Analysis of ultrafiltration failure in peritoneal dialysis patients by means of standard peritoneal permeability analysis. Perit Dial Int 17:144–150PubMed
64.
Mujais S, Nolph K, Blake P, Burkart J, Coles G, Kawaguchi Y, Kawanishi H, Korbet S, Krediet R, Lindholm B, Oreopoulus D, Rippe B, Selgas R (2000) Evaluation and management of ultrafiltration problems in peritoneal dialysis. Perit Dial Int 20 [Suppl 4]:S5–S21PubMed
65.
Kiernan L, Kliger A, Gorban-Brennan N, Juergensen P, Tesin D, Vonesh E, Finkelstein F (1995) Comparison of CAPD related infections with different, Y-tubing“exchange systems. J Am Soc Nephrol 5:1835–1838PubMed
66.
Monteon F, Corra-Rotter P, Paniagua R, Amato D, Hurtado ME, Medina JL, Salcedo RM, Garcia E, Matos M, Kaji J, Vazquez R, Ramos A, Schettino MA, Moran J (1998) Prevention of peritonitis with disconnect systems in CAPD. The Mexican Nephrology Collaborative Study Group. Kidney Int 54:2123–2128PubMed
67.
Warady BA, Schaefer FS (2004) Peritonitis. In: Warady BA, Schaefer FS, Fine RN, Alexander SR (eds) Pediatric dialysis. Kluwer Academic Publishers, Dordrecht, pp 393–413
68.
Dell’Aquila R, Rodighiero MP, Spano M, Di Loreto P, Ocampo Kohn C, Cruz D, Polanco N, Kuang D, Corradi V, De Cal M, Ronco C (2007) Advances in the technology of automated, tidal and continuous flow peritoneal dialysis. Perit Dial Int 27 [Suppl 2]:S130–S137PubMed
69.
Edefonti A, Boccola S, Picca M, Paglialonga F, Ardissino G, Marra G, Ghio L, Parisotto MT (2003) Treatment data during pediatric home peritoneal dialysis. Pediatr Nephrol 18:560–564PubMed
70.
Gallar P, Vigil A, Rodriguez I, Ortega O, Guterriez M, Hurtado J, Oliet A, Ortiz M, Mon C, Herrero JC, Lentisco C (2007) Two-year experience with telemedicine in the follow-up of patients in home peritoneal dialysis. J Telemed Telecare 13:288–292PubMed
71.
Nakamoto H (2007) Telemedicine system for patients on continuous ambulatory peritoneal dialysis. Perit Dial Int 27 [Suppl 2]:S21–S26PubMed
72.
Cargill A, Watson AR (2003) Telecare support for patients undergoing chronic peritoneal dialysis. Perit Dial Int 23:91–94PubMed
73.
Brunkhorst R, Fromm S, Wrenger E, Berke A, Petersen R, Riede G, Westphale J, Zamore E, Ledebo I (1998) Automated peritoneal dialysis with “online”-prepared bicarbonate-buffered dialysate: Technique and first clinical experiences. Nephrol Dial Transplant 13:3189–3192PubMed
74.
Ronco C, Amerling R (2006) Continuous flow peritoneal dialysis: current state-of-the-art and obstacles to further development. Contrib Nephrol 150:310–320PubMed
75.
Woodrow G (2007) Methodology of assessment of fluid status and ultrafiltration problems. Perit Dial Int 27 [Suppl 2]:S143–S147PubMed
76.
Fischbach M, Terzic J, Menouer S, Soulami K, Dangelser C, Helmstetter A, Gehant F (2001) Effects of automated peritoneal dialysis on residual daily urinary volume in children. Adv Perit Dial 17:269–273PubMed
77.
Morgenstern BZ, Wuhl E, Nair KS, Warady BA, Schaefer F (2006) Anthropometric prediction of total body water in children who are on pediatric peritoneal dialysis. J Am Soc Nephrol 17:285–293
Metadata
Title
Selection of modalities, prescription, and technical issues in children on peritoneal dialysis
Authors
Enrico Verrina
Valeria Cappelli
Francesco Perfumo
Publication date
01-08-2009
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 8/2009
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-008-0848-4

Other articles of this Issue 8/2009

Pediatric Nephrology 8/2009 Go to the issue

Brief Report

Fibrillary glomerulonephritis and renal failure in a child with systemic lupus erythematosus

Letter to the Editors

Efficacy of mycophenolate mofetil for steroid and cyclosporine resistant membranoproliferative glomerulonephritis type I

Brief Report

Efficacy of zinc supplements in reducing relapses in steroid-sensitive nephrotic syndrome

Original Article

Bedside diagnosis of outpatient childhood urinary tract infection using three-media dipslide culture test

Letter to the Editors

Hyponatremia in children with respiratory tract infection

Clinical Quiz

An unusual case of renal medullary hyperechogenicity and hypertension: question