Abstract:

Objective To evaluate the risk factors of chronic peritoneal dialysis (CPD) related peritonitis in children.Methods All end-stage renal disease (ESRD) patients who received the CPD in Children's Hospital of Fudan University were collected retrospectively. The patients were grouped as peritonitis group and non-peritonitis group. According to the consecutive follow-up data, demographic factors, dialysis characteristics and main indicators of dialysis adequacy were analyzed.Results A total of 109 children who received the CPD from 2001 to 2014 in our hospital were enrolled in this study. 60 cases (55%) were boys and the other 49 were girls. The median age started CPD was 9.9 years and median duration of dialysis was 13.4 months. 15 cases (13.8%) received continuous ambulatory peritoneal dialysis (CAPD) and the other 94 received automated peritoneal dialysis (APD). At the latest follow-up, 43 cases (39.4%) still received CPD, 50 cases (45.9%) received renal transplantation, 7 cases (6.4%) were transferred to hemodialysis, 6 cases (5.5%) died and the other 3 cases (2.8%) were lost to follow-up. 1-year, 2-year, 3 year and 5-year patient survival rate was 97.1%, 93.3%, 90.1% and 90.1%, respectively. Totally, 33 patients suffered from 57 times of peritonitis. The incidence of peritoneal dialysis related peritonitis was 1 episode per 35.1 patient-month. There were significant differences in height at the start of dialysis (P=0.01), duration of dialysis (P<0.001) and serum albumin level (P=0.01) between peritonitis group and non-peritonitis group. The results of Logistic regression analysis indicated that height SDS<-2.0 at the start of dialysis (OR=12.746, 95%CI: 2.436-66.675, P=0.003) and more than one year duration of dialysis (OR=8.162, 95%CI: 2.514-26.500, P<0.001) were the independent risk factors of peritoneal dialysis related peritonitis.Conclusion Height SDS<-2.0 at the start of dialysis and more than one year duration dialysis were the independent risk factors of peritoneal dialysis related peritonitis in children.