پديد آورندگان :
Hooman Nakysa نويسنده , Esfahani Seyed-Taher نويسنده , Mohkam Masoumeh نويسنده , Derakhshan Ali نويسنده , GHEISSARI ALALEH نويسنده , Vazirian Shams نويسنده , Mortazavi Fakhrossadat نويسنده , GHANE SHERBAFF FATEMEH نويسنده , Falak-Aflaki Behnaz نويسنده , Otoukesh Hasan نويسنده , Madani Abbas نويسنده , Sharifian-Dorcheh MOSTAFA نويسنده , Mahdavi Akerdi Ali Asghar نويسنده , Esmaeile Mohamad نويسنده , Naseri Mitra نويسنده , Azhir Afshin نويسنده , Merikhi Alireza نويسنده , Mohseni Parvin نويسنده , ATAEI NEAMATOLLAH نويسنده , FALLAHZADEH MOHAMMAD HOSSEIN نويسنده , BASIRATNIA MITRA نويسنده , HOSSEINI AL HASHEMI GHAMAR نويسنده
چكيده لاتين :
Background: Continuous ambulatory peritoneal dialysis is not a very common modality to
treat Iranian children with end-stage renal disease; however, there is sometimes no choice but to
offer this therapy to salvage the patient. Obviously, promotion in each program needs reevaluation
to find the pitfalls. Therefore, a nation-wide survey on pediatric continuous ambulatory
peritoneal dialysis was conducted to find the cause of death or termination of dialysis.
Methods: All children, younger than 14 years old, treated by continuous ambulatory peritoneal
dialysis in nine main pediatric nephrology wards in Iran between 1993 and 2006 were included in
this historical cohort study. Patient and technique survival rates were determined. Kaplan-Mayer
and Cox-regression analysis were used to compare the survival. 2)(2 table was used to calculate
the risk ratio. A P<0.05 was considered significant.
Results: One hundred twenty children with a mean age of 47.6 months were on continuous
ambulatory peritoneal dialysis. The most frequent cause of renal failure was hereditary-metaboliccystic
disease. One hundred eighty-two peritoneal dialysis catheters were inserted surgically. The
median first catheter exchange was 0.74 year (95%CI: 0.5 - 0.98). The most frequent cause of
catheter replacement was catheter outflow failure due to displacement, adhesion, and infection
(persistent peritonitis or tunnel infection). The mean patient survival was 1.22 years (95%CI: 0.91 1.53).
The mortality rate was 55% before 1997, and 60% between 1998 and 2001, which declined to
23% after 2002 (P(LESS THAN00.05). Young age «24 months) was the only independent factor that predicted
mortality (P(LESS THAN)O.05). The outcome of children was as follows: recovery of renal function (6.7%), renal
transplantation (8.3%), switch to hemodialysis (16.7%), still on continuous ambulatory peritoneal
dialysis (23.3%), death (43.3%), and lost to follow-up (1.7%).
Conclusion: The mortality is still high among Iranian children on peritoneal dialysis. Young
age is the most important factor influencing on survival and mortality.
