[The clinical significance of peritoneal transport in children during first year of peritoneal dialysis].

UNLABELLED: Peritoneal transport status is one of main prognostic factors in patients with end-stage renal disease (ESRD) treated with chronic peritoneal dialysis (PD). The aim of study was evaluation of influence of peritoneal transport status on selected clinical and biochemical parameters in children with ESRD in first year of PD treatment.

MATERIALS AND

METHODS

52 children (mean age 10.3 ± 4.7 years) with preserved residual renal function (RRF) treated with PD were enrolled into the study. In all patients we evaluated in first 12 months of PD treatment: peritoneal equilibration test (PET): D/P (Crea 4h), D/D0 Glu 4h, age, sex, etiology of ESRD, blood pressure, RRF (daily diuresis [mL/kg/24h], residual GFR [mL/min/1.73 m2]), PD parameters, adequacy, rate of PD-related peritonitis, medications, and biochemical parameters.

RESULTS

Mean D/P (Crea 4h) was 0.65 ± 0.13, mean D/D0 glu 4h-0.38 ± 0.13. Patients were divided into 2 groups: H/HA (high/high-average) peritoneal permeability--26 (50.0%) and L/LA (low/low-average)--26 (50.0%) children. Patients with H/HA were significantly (P < 0.05): younger, had slower growth rate, higher systolic blood pressure, worse control of arterial hypertension, slower rates of rGFR and twCCr (total weekly clearance of creatinine) decline, higher incidence of peritonitis, lower total protein and albumin; tendency to lower hemoglobin (P = 0.07) compared to patients with L/LA.

CONCLUSIONS

High peritoneal permeability in children with ESRD treated with chronic peritoneal dialysis may be a risk factor for slower growth rate, systolic hypertension, peritonitis and metabolic disturbances: anemia, hypoproteinemia and hypoalbuminemia. Rate of GFR decline is slower in children with high peritoneal transport status.