ESPN 51th Annual Meeting

ESPN 2018


 
Peritoneal dialysis (PD) should not be contra-indicated in anephric children
WAFAA NOUREDDINE 1 HIBA TRRAF 1 JUSTINE BACCHETTA 1 ANNE-LAURE SELLIER-LECLERC 1 AURELIA BERTHOLET-THOMAS 1 DELPHINE DEMEDE 1 ETIENNE JAVOUHEY 1 PIERRE COCHAT 1 BRUNO RANCHIN 1

1- HOSPICES CIVILS DE LYON ET UNIVERSITé CLAUDE-BERNARD LYON1, LYON, FRANCE
 
Introduction:

Lack of residual function may contra-indicate PD in children.

Material and methods:

We performed a retrospective analysis of all anephric children who began chronic automated PD in our unit between January 2003 and January 2018. Results are presented as median (min;max). Growth was evaluated according to WHO charts.

Results:

11 children (9 girls), all with nephrotic syndrome (NS), were included: Denys-Drash Sd (N=3), Finnish type NS (N=5), and other steroid resistant NS (N=3). At PD initiation, age was 44 (5;182) months; body weight -0.71 (-2.37;0.95) SDS, and height -0.64 (-1.27;0.23) SDS. PD duration was 16.1 (8.0;26.8) months. One child received growth hormone therapy, 9 children received enteral nutritional support, 8 children displayed hypertension during the PD course that was persistent at PD withdrawal in 4. During PD, average PTH levels were 264 (110;506) ng/L. PD duration per night was 11.6 (10.7;13.0) hours. Dialysate total volume was 10584 (9651;12619) mL/m2, volume per night and day cycles were 949 (829;1102) mL/m2 and 421 (332;558) mL/m2, respectively. PD was discontinued in 8 children who underwent transplantation at 5.9 (1.3;16.1) years of age, 2 children were switched to hemodialysis after 13 and 20 months on PD for insufficient ultrafiltration, 1 child is still on PD. At the end of PD, body weight-SDS was 0.07 (-0.73;1.38), and height-SDS -0.54 (-1.9;1.63). Body weight-SDS and height-SDS variations during the course of PD were 0.78 (-0.44;2.93) and 0.09 (-2.13;2.28), respectively.

Conclusions:

PD should not be contra-indicated in anephric children, provided a close follow-up, attentive nutritional management and the use of daily long overnight PD sessions.