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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Current practice of peritoneal dialysis in children: results of a longitudinal survey. Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS).
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Current practice of peritoneal dialysis in children: results of a longitudinal survey. Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS).

机译：儿童腹膜透析的现行做法：纵向调查的结果。欧洲中小儿腹膜透析研究组（MEPPS）。

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Since 1993, the Mid European Pediatric Peritoneal Dialysis Study Group (MEPPS) has been accumulating epidemiological data regarding the practice of peritoneal dialysis (PD) in children. More than 200 children have been evaluated to date. While treatment modalities were evenly distributed in 1993, automated peritoneal dialysis (APD) has emerged as the preferred mode of therapy during the last few years. Technique survival was 95% at 2 years, but decreased to 65% after 4 years of treatment, the main reasons for treatment failure being recurrent peritonitis, ultrafiltration failure, or both. Most centers use double-cuff curled Tenckhoff catheters with an upward pointing exit site. The first catheter was still functioning in 82% of patients after 1 year, and in 57% of patients after 4 years of treatment. While the overall peritonitis incidence between 1993 and 1997 was 1 episode per 17 months, it was much higher in children below 6 years of age. Empirical PD prescription resulted in a mean total weekly creatinine clearance of 57 L/1.73 m2/week in both continuous ambulatory peritoneal dialysis (CAPD) and APD patients, while average total weekly Kt/V urea was higher in APD-treated (2.45) than in CAPD-treated children (1.96). Antihypertensive treatment was required in 40%-50% of patients; oral phosphate binders in 75%-80%; bicarbonate substitution in 30%; potassium binders in 7%-14%; and NaCl supplementation in 9%-21% of patients. While growth retardation had a prevalence of 57%, body mass relative to height was in the normal range. After one year of dialysis, 20% of patients received growth hormone treatment. In conclusion, peritoneal dialysis in children, preferably performed as APD, achieves technique survival rates similar to those reported for adults. Young children are at increased risk for peritonitis. The current empirical PD prescription is of limited efficacy in terms of small-solute and fluid removal.
机译：自1993年以来，中欧儿科腹膜透析研究组（MEPPS）一直在收集有关儿童腹膜透析（PD）的流行病学数据。迄今为止，已经评估了200多名儿童。 1993年，虽然治疗方式均匀分布，但自动腹膜透析（APD）在最近几年已成为首选的治疗方式。在2年时，技术存活率为95％，但在治疗4年后降至65％，治疗失败的主要原因是复发性腹膜炎，超滤失败或两者兼而有之。大多数中心使用双袖卷曲的Tenckhoff导管，其出口指向上。一年后，有82％的患者使用第一根导管，治疗4年后，仍有57％的患者使用了第一根导管。虽然1993年至1997年之间的整体腹膜炎发病率是每17个月1次发作，但6岁以下儿童的腹膜炎发病率要高得多。经验性PD处方在连续非卧床腹膜透析（CAPD）和APD患者中平均每周总肌酐清除率为57 L / 1.73 m2 /周，而APD治疗的平均每周总Kt / V尿素水平高于（2.45）在接受CAPD治疗的儿童中（1.96）。 40％-50％的患者需要进行降压治疗;口服磷酸盐粘合剂占75％-80％;碳酸氢盐取代率为30％;钾粘合剂的含量为7％-14％; 9％-21％的患者补充NaCl。尽管发育迟缓的患病率为57％，但相对于身高的体重处于正常范围。透析一年后，有20％的患者接受了生长激素治疗。总而言之，儿童腹膜透析最好采用APD进行，其技术存活率与成人报告的相似。幼儿患腹膜炎的风险增加。当前的经验性PD处方在小溶质和液体去除方面效果有限。

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