Kuizon B, Melocoton T L, Holloway M, Ingles S, Fonkalsrud E W, Salusky I B
Department of Pediatrics, UCLA School of Medicine, USA.
Pediatr Nephrol. 1995;9 Suppl:S12-7. doi: 10.1007/BF00867677.
Continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) are the predominant dialytic modalities for the majority of children while awaiting transplantation. Wide acceptability of peritoneal dialysis is hindered by infectious complications. A retrospective review of 367 pediatric patients treated with CAPD/CCPD for at least 3 months from September 1980 through December 1994 revealed that the peritonitis incidence ranged from 1.7 to 0.78 episodes per patient-year. No differences in peritonitis rates were observed between patients treated with CAPD or CCPD. Gram-positive organisms were responsible for the majority of peritonitis episodes. Age, sex, race, primary renal disease, presence of nephrotic syndrome, and serum albumin level were not associated risk factors. Longer time on treatment and diminished serum IgG level were associated with increased peritonitis incidence. Treatment was successfully completed at home in most cases. Almost half of the catheter losses were caused by Staphylococcus, Pseudomonas, and fungal peritonitis and tunnel/exit-site infections. Infectious complications are still the major causes of morbidity and treatment failure in patients treated with CAPD/CCPD. Thus, controlled studies are needed to assess methods for prevention or improvement of peritonitis rates in this patient population.
持续非卧床腹膜透析（CAPD）和持续循环腹膜透析（CCPD）是大多数等待移植的儿童的主要透析方式。腹膜透析的广泛接受度受到感染性并发症的阻碍。一项对1980年9月至1994年12月期间接受CAPD/CCPD治疗至少3个月的367例儿科患者的回顾性研究显示，腹膜炎发病率为每位患者每年1.7至0.78次发作。接受CAPD或CCPD治疗的患者之间腹膜炎发生率没有差异。革兰氏阳性菌是大多数腹膜炎发作的原因。年龄、性别、种族、原发性肾病、肾病综合征的存在以及血清白蛋白水平均不是相关的危险因素。治疗时间延长和血清IgG水平降低与腹膜炎发病率增加有关。大多数情况下治疗在家庭中成功完成。几乎一半的导管丢失是由金黄色葡萄球菌、铜绿假单胞菌和真菌性腹膜炎以及隧道/出口部位感染引起的。感染性并发症仍然是接受CAPD/CCPD治疗的患者发病和治疗失败的主要原因。因此，需要进行对照研究来评估预防或改善该患者群体腹膜炎发生率的方法。
