Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis

Sharon Andreoli, Carl D. Langefeld, Sally Stadler, Paula Smith, Allison Sears, Karen West

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Children undergoing long-term peritoneal dialysis are at risk for membrane injury, necessitating conversion to hemodialysis. We analyzed the incidence and risk factors for membrane failure (inadequate ultrafiltration with or without peritoneal adhesions and decreased peritoneal surface area) in 68 children maintained with peritoneal dialysis for more than 3 months at our institution. The overall incidence of membrane failure was 16.2% (11/68). Kaplan-Meier estimates of peritoneal membrane survival were 88% at 24 months, 72% at 36 months, 65% at 48 months, and 52% at 60 months. Logistic regression analysis demonstrated that the risk of membrane failure increased with the number of episodes of peritonitis (odds ratio 1.61). The rate of peritonitis was 1 per 7.02 patient months in children who developed membrane failure compared with 1 per 9.18 patient months in children without membrane failures but the rate of peritonitis was not predictive of membrane failure (P=0.09). Multiple logistic regression analysis demonstrated that peritonitis caused by Pseudomonas aeruginosa or alpha streptococcal organisms were independent predictors of membrane failure. We conclude that peritoneal membrane survival declines substantially with time on peritoneal dialysis and that membrane failure is associated with peritonitis, particularly peritonitis caused by Pseudomonas aeruginosa and alpha streptococcal organisms. The mechanism(s) of membrane injury are unknown but may be related to the inflammatory response initiated during peritonitis.

Original languageEnglish
Pages (from-to)543-547
Number of pages5
JournalPediatric Nephrology
Volume7
Issue number5
DOIs
StatePublished - Oct 1993

Fingerprint

Peritoneal Dialysis
Membranes
Peritonitis
Pseudomonas aeruginosa
Logistic Models
Regression Analysis
Incidence
Wounds and Injuries
Ultrafiltration
Kaplan-Meier Estimate
Renal Dialysis
Odds Ratio

Keywords

  • Alpha streptococci
  • Peritoneal dialysis
  • Peritoneal membrane
  • Peritonitis
  • Pseudomonas aeruginosa
  • Ultrafiltration

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis. / Andreoli, Sharon; Langefeld, Carl D.; Stadler, Sally; Smith, Paula; Sears, Allison; West, Karen.

In: Pediatric Nephrology, Vol. 7, No. 5, 10.1993, p. 543-547.

Research output: Contribution to journalArticle

Andreoli, Sharon ; Langefeld, Carl D. ; Stadler, Sally ; Smith, Paula ; Sears, Allison ; West, Karen. / Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis. In: Pediatric Nephrology. 1993 ; Vol. 7, No. 5. pp. 543-547.
@article{e9493120c47d49fa80296e6c08a9ed1b,
title = "Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis",
abstract = "Children undergoing long-term peritoneal dialysis are at risk for membrane injury, necessitating conversion to hemodialysis. We analyzed the incidence and risk factors for membrane failure (inadequate ultrafiltration with or without peritoneal adhesions and decreased peritoneal surface area) in 68 children maintained with peritoneal dialysis for more than 3 months at our institution. The overall incidence of membrane failure was 16.2{\%} (11/68). Kaplan-Meier estimates of peritoneal membrane survival were 88{\%} at 24 months, 72{\%} at 36 months, 65{\%} at 48 months, and 52{\%} at 60 months. Logistic regression analysis demonstrated that the risk of membrane failure increased with the number of episodes of peritonitis (odds ratio 1.61). The rate of peritonitis was 1 per 7.02 patient months in children who developed membrane failure compared with 1 per 9.18 patient months in children without membrane failures but the rate of peritonitis was not predictive of membrane failure (P=0.09). Multiple logistic regression analysis demonstrated that peritonitis caused by Pseudomonas aeruginosa or alpha streptococcal organisms were independent predictors of membrane failure. We conclude that peritoneal membrane survival declines substantially with time on peritoneal dialysis and that membrane failure is associated with peritonitis, particularly peritonitis caused by Pseudomonas aeruginosa and alpha streptococcal organisms. The mechanism(s) of membrane injury are unknown but may be related to the inflammatory response initiated during peritonitis.",
keywords = "Alpha streptococci, Peritoneal dialysis, Peritoneal membrane, Peritonitis, Pseudomonas aeruginosa, Ultrafiltration",
author = "Sharon Andreoli and Langefeld, {Carl D.} and Sally Stadler and Paula Smith and Allison Sears and Karen West",
year = "1993",
month = "10",
doi = "10.1007/BF00852541",
language = "English",
volume = "7",
pages = "543--547",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Risks of peritoneal membrane failure in children undergoing long-term peritoneal dialysis

AU - Andreoli, Sharon

AU - Langefeld, Carl D.

AU - Stadler, Sally

AU - Smith, Paula

AU - Sears, Allison

AU - West, Karen

PY - 1993/10

Y1 - 1993/10

N2 - Children undergoing long-term peritoneal dialysis are at risk for membrane injury, necessitating conversion to hemodialysis. We analyzed the incidence and risk factors for membrane failure (inadequate ultrafiltration with or without peritoneal adhesions and decreased peritoneal surface area) in 68 children maintained with peritoneal dialysis for more than 3 months at our institution. The overall incidence of membrane failure was 16.2% (11/68). Kaplan-Meier estimates of peritoneal membrane survival were 88% at 24 months, 72% at 36 months, 65% at 48 months, and 52% at 60 months. Logistic regression analysis demonstrated that the risk of membrane failure increased with the number of episodes of peritonitis (odds ratio 1.61). The rate of peritonitis was 1 per 7.02 patient months in children who developed membrane failure compared with 1 per 9.18 patient months in children without membrane failures but the rate of peritonitis was not predictive of membrane failure (P=0.09). Multiple logistic regression analysis demonstrated that peritonitis caused by Pseudomonas aeruginosa or alpha streptococcal organisms were independent predictors of membrane failure. We conclude that peritoneal membrane survival declines substantially with time on peritoneal dialysis and that membrane failure is associated with peritonitis, particularly peritonitis caused by Pseudomonas aeruginosa and alpha streptococcal organisms. The mechanism(s) of membrane injury are unknown but may be related to the inflammatory response initiated during peritonitis.

AB - Children undergoing long-term peritoneal dialysis are at risk for membrane injury, necessitating conversion to hemodialysis. We analyzed the incidence and risk factors for membrane failure (inadequate ultrafiltration with or without peritoneal adhesions and decreased peritoneal surface area) in 68 children maintained with peritoneal dialysis for more than 3 months at our institution. The overall incidence of membrane failure was 16.2% (11/68). Kaplan-Meier estimates of peritoneal membrane survival were 88% at 24 months, 72% at 36 months, 65% at 48 months, and 52% at 60 months. Logistic regression analysis demonstrated that the risk of membrane failure increased with the number of episodes of peritonitis (odds ratio 1.61). The rate of peritonitis was 1 per 7.02 patient months in children who developed membrane failure compared with 1 per 9.18 patient months in children without membrane failures but the rate of peritonitis was not predictive of membrane failure (P=0.09). Multiple logistic regression analysis demonstrated that peritonitis caused by Pseudomonas aeruginosa or alpha streptococcal organisms were independent predictors of membrane failure. We conclude that peritoneal membrane survival declines substantially with time on peritoneal dialysis and that membrane failure is associated with peritonitis, particularly peritonitis caused by Pseudomonas aeruginosa and alpha streptococcal organisms. The mechanism(s) of membrane injury are unknown but may be related to the inflammatory response initiated during peritonitis.

KW - Alpha streptococci

KW - Peritoneal dialysis

KW - Peritoneal membrane

KW - Peritonitis

KW - Pseudomonas aeruginosa

KW - Ultrafiltration

UR - http://www.scopus.com/inward/record.url?scp=0027428419&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027428419&partnerID=8YFLogxK

U2 - 10.1007/BF00852541

DO - 10.1007/BF00852541

M3 - Article

VL - 7

SP - 543

EP - 547

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 5

ER -