Department of Nephrology, First Affiliated Hospital of Xian Jiaotong University, Xi'an, China.
Department of Nephrology, First Affiliated Hospital of Xian Jiaotong University, Xi'an, China,
Blood Purif. 2019;48(4):315-320. doi: 10.1159/000502079. Epub 2019 Jul 29.
Peritoneal dialysis (PD) is a kind of renal replacement therapy (RRT), which can be employed to treat pediatric acute kidney injury (AKI) as it is safe, simple, and cost-effective. The studies of PD treatment in pediatric AKI in China have rarely been reported in English literature.
To investigate the efficacy and the outcome of PD in pediatric patients with AKI.
We performed a retrospective study of children who received PD as RRT for AKI in a teaching hospital in northwest China from 2003 to 2013. Demographic characteristics and laboratory data were collected, and the prognostic factors of renal recovery were identified.
There were 24 children (62.5% male) identified, with the mean age of 22.4 ± 18.7 months (3 months to 5 years old). The most common causes of AKI were drug induced (25.0%), glomerulonephritis (20.9%), and obstructive nephropathy (16.7%). The mean duration of PD was 11.3 ± 7.8 days (2-39 days). PD treatment was highly effective in attenuation of toxics, improvement of fluid overload, and correction of electrolyte disturbances (p < 0.001). One catheter outflow obstruction was noted, and no major complication was identified. In total, 18 children (75.0%) recovered and had the catheter successfully removed, 2 (8.3%) needed further PD treatment, and 4 (16.7%) died. The albumin level was significantly higher in patients who recovered with PD treatment (33.7 ± 6.2 vs. 21.5 ± 4.8 g/L, p = 0.002).
PD can be performed safely and efficiently for the treatment of pediatric AKI. Low albumin level may be associated with poor prognosis of pediatric AKI.
腹膜透析（PD）是一种肾脏替代疗法（RRT），可用于治疗儿科急性肾损伤（AKI），因为它安全、简单且具有成本效益。中国关于 PD 治疗儿科 AKI 的研究在英文文献中很少报道。
探讨 PD 在儿科 AKI 患者中的疗效和结局。
我们对中国西北地区一家教学医院 2003 年至 2013 年期间接受 PD 作为 AKI RRT 的儿童进行了回顾性研究。收集了人口统计学特征和实验室数据，并确定了肾功能恢复的预后因素。
共纳入 24 例儿童（62.5%为男性），平均年龄为 22.4±18.7 个月（3 个月至 5 岁）。AKI 的最常见病因是药物诱导（25.0%）、肾小球肾炎（20.9%）和梗阻性肾病（16.7%）。PD 的平均治疗时间为 11.3±7.8 天（2-39 天）。PD 治疗在减轻毒素、改善液体超负荷和纠正电解质紊乱方面非常有效（p<0.001）。仅发生 1 例导管流出道阻塞，未发现重大并发症。共有 18 例（75.0%）儿童成功恢复并拔出导管，2 例（8.3%）需要进一步 PD 治疗，4 例（16.7%）死亡。在 PD 治疗后恢复的患者中，白蛋白水平明显更高（33.7±6.2 vs. 21.5±4.8 g/L，p=0.002）。
PD 可安全有效地用于治疗儿科 AKI。低白蛋白水平可能与儿科 AKI 的不良预后相关。
