Continuous ambulatory peritoneal dialysis in a program for children with end stage renal disease

Eighteen infants, children, and adolescents were trained in the techniques of continuous ambulatory peritoneal dialysis (CAPD) as a therapy for end stage renal disease (ESRD) at the University of Florida. Fourteen patients successfully continued CAPD 4–24 months, for a total of 193 patient-months.Uremic symptoms were well controlled with blood urea nitrogen concentration (BUN) decreased to between 60 and 80mg/dl. Parathyroid hormone levels increased but roentgenographic evidence of osteodystrophy improved in most patients. The rate of peritonitis was one episode in 7.7 patient-months. Blood transfusion requirements decreased for patients transferred from in-center hemodialysis to CAPD with no significant decrease in average hematocrits. Caloric intake was adequate and anorexia was usually not a major problem. Children who were evaluated for growth were under 15 years of age, with bone ages less than 12 years, and were using CAPD for longer than 6 months. Their mean growth velocity was 74.7±20.4% (SD) of the predicted velocity.This study was supported in part by The Comprehensive Children's Kidney Failure Center Grant from the Children's Medical Services, a program of the State of Florida Department of Health and Rehabilitative Services