Current State of Peritoneal Dialysis in Children

摘要

Background: Recent statistics have revealed that the number of patients with preemptive kidney transplant (KTx) has increased to 21.9% between 2006 and 2011. However, factors like body height, lack of kidney source, and severe complications render some patients ineligible for KTx. Peritoneal dialysis (PD) acts as the bridging therapy to KTx, especially for infants and young children. Because the period of PD treatment is relatively longer in Japan due to the lack of kidney donors, management of PD is imperative for the success of the treatment. Summary: Pediatric patients receiving PD treatment present several characteristics similar to adult patients. A small number of patients could result in the lack of experience accumulation, such as treatment/patient education or shortage of specialized nurses/social workers, at each hospital. Recent advancements in the treatment of glomeru-lonephritis and steroid-resistant nephrotic syndrome might reduce the incidence rate of end-stage renal disease. Recently, the frequency of congenital diseases, such as congenital anomalies of the kidney and urinary tract (CAKUT) and patients ranging from infants to young children, has relatively increased. Because polyuria is a characteristic of CAKUT, PD is used for solute removal, and urine is used for fluid management. The incidence of comorbidities is not negligible. In this study, approximately half of the patients received KTx from their parents. Key Messages: Because PD is the only treatment option available to patients, especially infants and young children, to become a bridge to KTx, its management and outcome must be efficient.