PURPOSE: To find and solve the common problems of peritoneal dialysis (PD) by analyzing the clinical data of pediatric PD performed in Korea.METHODS: We looked at 264 cases of continuous ambulatory peritoneal dialysis (CAPD) and acute PD that were performed in 18 institutions of pediatric nephrology in Korea from November 1987 to October 1997.RESULTS: CAPD was performed in 114 cases. The mean age of the patients was 10.5+/-6.6 years, and the male-to-female ratio was 1.4:1. The original causes of end-stage renal disease (ESRD) were proven in 92 cases (81%). The most common renal diseases were focal segmental glomerulosclerosis (17%), reflux nephropathy (11%), and chronic glomerulonephritis (11%). Mean duration of CAPD was 20 months+/-16.9 months. Peritonitis was the most common complication, and the peritonitis incidence was 0.96 episode per patient-year. Other complications were exit-site infection in 10 cases, obstruction in 7 cases, and leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was Staphylococcus aureus and the next most common was coagulase-negative staphylococcus. Acute PD was performed in 150 cases. The most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis, and dehydration. The mean duration was 10.3+/-11.3 days. The most common complication was peritonitis (78.3%). The most common etiologic organisms of peritonitis were Staphylococcus aureus, coag-neg staphylococcus, Acinetobacter, and Pseudomonas.CONCLUSION: Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly (7%) as a original cause of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis rapidly increased at 2 weeks after the start of dialysis.
Adolescent Child