Pediatric Peritoneal Dialysis in Korea : Practical Solution to the Problems of Peritoneal Dialysis for Children

Kim, Pyung-Kil

J Korean Soc Pediatr Nephrol > Volume 2(2); > Article

한국 소아복막투석의 현황 - 다기관 공동연구 결과보고 -

김병길

연세대학교 의과대학 소아과학교실 및 대한소아신장학회

Pediatric Peritoneal Dialysis in Korea : Practical Solution to the Problems of Peritoneal Dialysis for Children

Pyung-Kil Kim

Department of pediatrics, Yonsei University, College of Medicine and The Korean Society of Pediatric Nephrology

ABSTRACT

Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea.
Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea.
Results : CAPD was performed in 114 cases. The mean age of the patients was 10.5+/-6.6 years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases(80%). The common renal disease of ESRD were FSGS(17%), reflux nephropathy (11%), chronic glomerulonephritis(9.6%). Mean duration of CAPD was 20+/-16.9 months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was 10.3+/-11.3 days. The most common complication was peritonitis(20.6%). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas.
Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly(7%) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

Key words: Peritoneal dialysis | Children | Korea