Continuous ambulatory and continuous cycling peritoneal dialysis in children. A report of the Southwest Pediatric Nephrology Study Group

Continuous ambulatory and continuous cycling peritoneal dialysis in children. A report of the Southwest Pediatric Nephrology Study Group. Continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) have become acceptable methods of treatment for children with endstage renal disease (ESRD). In this study we have compared the effectiveness of these two modalities of prolonged dwell peritoneal dialysis in 82 children treated at home with CAPD and/or CCPD for a mean of 10.2 months. Forty variables were evaluated during 92 patient periods (63 CAPD, 29 CCPD). There was no difference between the two groups with regard to sex, race, original disease, duration of dialysis, or volume of dialysis fluid. The only difference in biochemical profiles between the two groups was a higher serum creatinine in CCPD patients due in part to this group's greater age. The rate of peritonitis was not different (CAPD 1/4.6, CCPD 1/5.2 months), but the number of patient periods devoid of peritonitis was greater in the CCPD group (14/29 vs. 17/63, P=0.04). Growth velocity index (GVI) and standard deviation scores (SD scores) were used to evaluate growth in the total group and subsets according to age. Overall GVI was 88% of expected and did not differ between PD groups (CAPD 88% vs. CCPD 89%). There were no significant changes in SD scores for growth during the course of prolonged dwell peritoneal dialysis indicating that the children did not experience further deterioration in growth. Children less than 4 years of age also did not have significant changes in SD scores. We conclude that CAPD and CCPD provide acceptable and comparable modes of dialytic therapy for children with ESRD. Dialyse peritoneale continue ambulatoire et recyclage continu chez des enfants. Rapport du Southwest Pediatric Nephrology Study Group. La dialyse peritoneale continue ambulatoire (CAPD) et la dialyse peritoneale recyclage continu (CCPD) sont devenues des methodes acceptables chez les enfants en ESRD. Dans cette etude, nous avons compare l'efficacite de ces deux modalites de dialyse peritoneale a demeure prolongee chez 82 enfants traites a domicile par CAPD et/ou CCPD pendant 10,2 mois en moyenne. Quarante variables ont ete evaluees pendant 92 periodes-malades (63 CAPD, 29 CCPD). Il n'y avait pas de difference entre les deux groupes quant au sexe, la race, la maladie initiale, la duree de dialyse ou le volume de liquide de dialyse. La seule difference dans les profils biochimiques entre les deux groupes etait une creatininemie plus elevee chez les malades en CCPD, en partie a cause du plus grand âge de ce groupe. Le taux de peritonite n'etait pas different (CAPD 1/4,6, CCPD 1/5,2 mois), mais le nombre de malades sans episode de peritonite etait plus eleve dans le groupe CCPD (14/29 contre 17/62, P=0,04). L'index de vitesse de croissance (GVI) et les scores de deviation standard (SD/scores) ont ete utilises pour evaluer la croissance chez les enfants et les sous-groupes en fonction de l'âge. Globalement, GVI etait 84% de la valeur attendue, et ne differait pas entre les groupes PD (CAPD 88% contre CCPD 89%). Il n'existait pas de modification significative des scores de SD pour la croissance au cours de la dialyse peritoneale a demeure prolongee, indiquant que les enfants n'avaient pas eu de degradation supplementaire de leur croissance. Les enfants âges de moins de 4 ans n'avaient pas non plus de changements significatifs des scores de SD. Nous concluons que la CAPD et la CCPD constituent des modes acceptables et comparables de traitement dialytique chez les enfants en ESRD.