Honda M, Iitaka K, Kawaguchi H, Hoshii S, Akashi S, Kohsaka T, Tuzuki K, Yamaoka K, Yoshikawa N, Karashima S, Itoh Y, Hatae K
Department of Pediatric Nephrology, Tokyo Metropolitan Children's Hospital, Japan.
Perit Dial Int. 1996 May-Jun;16(3):269-75.
Over the past 10 years, we have collected data on pediatric patients less than 16 years of age from the National Registry of CAPD (continuous ambulatory peritoneal dialysis). We present our experience with this population.
The database details the patient number, age, weight, height, outcome, cause of death, reason for terminating CAPD therapy, peritonitis, and catheter survival.
Of the 434 patients (239 males, 195 females), 37 patients (8.5%) were under 1 year of age and 164 patients (37.8%) were under 6 years of age. About half of the patients were less than 20 kg in weight, clearly indicating that CAPD was the treatment of choice in young children. The duration on CAPD for these patients was less than 2 years for 233 patients (54%), and was 5 years or more in 48 patients (11%).
The outcome of the total patient population of 434 as of May, 1991, is as follows: 229 patients (52.8%) were being successfully treated with CAPD, 47 patients (10.8%) died, and 78 patients (18.0%) received a kidney transplantation. The patient survival rate was 85.6% at 3 years and 81.7% at 5 years. The technique survival rate was 74.9% at 3 years and 63.5% at 5 years. The rate of peritonitis was one episode over 28.6 patient-months. The mean catheter duration was 1.68 years. Peritonitis rate, catheter survival rate, and the rate of tunnel infection were worse in children less than 6 years of age than in older children.
The excellent patient and technique survival rates indicate that CAPD is an effective treatment for children with end-stage renal disease in Japan. The high infection rates in younger children indicate that extra careful management is needed for this young age group.
在过去10年里，我们从持续性非卧床腹膜透析（CAPD）国家登记处收集了16岁以下儿科患者的数据。我们介绍我们在这一人群中的经验。
数据库详细记录了患者数量、年龄、体重、身高、结局、死亡原因、终止CAPD治疗的原因、腹膜炎及导管留存情况。
434例患者（239例男性，195例女性）中，37例（8.5%）年龄在1岁以下，164例（37.8%）年龄在6岁以下。约一半患者体重不足20千克，这清楚表明CAPD是幼儿的首选治疗方法。这些患者接受CAPD治疗的时间，233例（54%）少于2年，48例（11%）为5年或更长时间。
截至1991年5月，434例患者的总体结局如下：229例（52.8%）接受CAPD治疗成功，47例（10.8%）死亡，78例（18.0%）接受了肾移植。3年时患者生存率为85.6%，5年时为81.7%。3年时技术生存率为74.9%，5年时为63.5%。腹膜炎发生率为每28.6患者月1次。导管平均留存时间为1.68年。6岁以下儿童的腹膜炎发生率、导管留存率和隧道感染率比大龄儿童更差。
优异的患者生存率和技术生存率表明，CAPD是日本终末期肾病患儿的有效治疗方法。年幼儿童的高感染率表明，这一年龄组需要格外谨慎的管理。
