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腹膜透析:突尼斯查尔斯·尼科勒医院儿科的经验

Peritoneal dialysis: Experience of the department of pediatrics of the hospital Charles Nicolle of Tunis.

作者信息

Jellouli Manel, Ferjani Meriem, Oueslati Amal, Abidi Kamel, Naija Ouns, Hammi Yousra, Ben Abdallah Taieb, Gargah Tahar

出版信息

Tunis Med. 2016 May;94(5):368-374.

Abstract

Introduction Peritoneal dialysis (PD) is still the most common modality used in treatment for children with End Stage Renal Disease (ESRD). The objective of this study was to identify the epidemiological, clinical, and microbiological factors affecting the outcome of PD. Methods In this study, we retrospectively reviewed the records of 85 patients who were treated with DP for the last ten years (from January 2004 to December 2013) in the Department of Pediatrics in Charles Nicolle hospital, Tunis. Results The mean duration of PD was 18.1±12 months (3.5-75 months). The average age of PD onset was 9.3±5.7 years (29 days-23 years). The sex ratio was 1.5. In a significant number of cases with ESRD, the primary cause is Congenital Anomalies of the Kidneys and Urinary Tract (CAKUT). Seventy-four of our patients (87%) had been treated with Automated PD. The average time between catheter placement and PD commencement was 3.9±4.6 days. Catheter change was 1.62 (1-5). Sixty-one patients (71.8%) had experienced at least one episode of peritonitis. The most frequently isolated organisms was the Gram-positive bacteria (61%). Survival rates without peritonitis at 12th, 24th and 36th months were 40%, 32% and 18%, respectively. Transition to permanent hemodialysis was required in 66% of patients. Conclusion Considering the important incidence of peritonitis in our patients, it is imperative to establish a targeted primary prevention.

摘要

引言 腹膜透析(PD)仍是终末期肾病(ESRD)患儿最常用的治疗方式。本研究的目的是确定影响腹膜透析治疗结局的流行病学、临床和微生物学因素。方法 在本研究中,我们回顾性分析了突尼斯查尔斯·尼科勒医院儿科过去十年(2004年1月至2013年12月)接受腹膜透析治疗的85例患者的记录。结果 腹膜透析的平均持续时间为18.1±12个月(3.5 - 75个月)。腹膜透析开始的平均年龄为9.3±5.7岁(29天 - 23岁)。性别比为1.5。在大量终末期肾病病例中,主要病因是先天性肾脏和尿路畸形(CAKUT)。我们的74例患者(87%)接受了自动化腹膜透析治疗。置管与开始腹膜透析之间的平均时间为3.9±4.6天。导管更换次数为1.62次(1 - 5次)。61例患者(71.8%)至少经历过一次腹膜炎发作。最常分离出的微生物是革兰氏阳性菌(61%)。第12、24和36个月无腹膜炎的生存率分别为40%、32%和18%。66%的患者需要转为永久性血液透析。结论 鉴于我们患者中腹膜炎的发生率较高,必须开展有针对性的一级预防。

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