Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group


Schmitt C. P., BAKKALOĞLU EZGÜ S. A., Klaus G., Schroder C., Fischbach M.

PEDIATRIC NEPHROLOGY, cilt.26, sa.7, ss.1137-1147, 2011 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 7
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1007/s00467-011-1863-4
  • Dergi Adı: PEDIATRIC NEPHROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1137-1147
  • Anahtar Kelimeler: Peritoneal dialysis fluids, Pediatrics, Biocompatible, Icodextrin, Amino acid, Consensus, Glucose degradation products, GLUCOSE DEGRADATION-PRODUCTS, ADVANCED GLYCATION ENDPRODUCTS, ENDOTHELIAL GROWTH-FACTOR, RESIDUAL RENAL-FUNCTION, AMINO-ACID, LONG-TERM, MESOTHELIAL CELL, BLOOD-PRESSURE, CLINICAL-EXPERIENCE, CAPD PATIENTS
  • Gazi Üniversitesi Adresli: Evet

Özet

The purpose of this article is to provide recommendations on the choice of peritoneal dialysis (PD) fluids in children by the European Pediatric Dialysis Working Group. The literature on experimental and clinical studies with PD solutions in children and adults was analyzed together with consensus discussions within the group. A grading was performed based on the international KDIGO nomenclature and methods. The lowest glucose concentration possible should be used. Icodextrin may be applied once daily during the long dwell, in particular in children with insufficient ultrafiltration. Infants on PD are at risk of ultrafiltration-associated sodium depletion, while anuric adolescents may have water and salt overload. Hence, the sodium chloride balance needs to be closely monitored. In growing children, the calcium balance should be positive and dialysate calcium adapted according to individual needs. Limited clinical experience with amino acid-based PD fluids in children suggests good tolerability. The anabolic effect, however, is small; adequate enteral nutrition is preferred. CPD fluids with reduced glucose degradation products (GDP) content reduce local and systemic toxicity and should be preferred whenever possible. Correction of metabolic acidosis is superior with pH neutral bicarbonate-based fluids compared with single-chamber, acidic, lactate-based solutions. Prospective comparisons of low GDP solutions with different buffer compositions are still few, and firm recommendations cannot yet be given, except when hepatic lactate metabolism is severely compromised.