#5577 PERITONEAL DIALYSIS COMPLICATIONS IN PEDIATRICS: A TUNISION EXPERIENCE

Abstract

Abstract Background and Aims Peritoneal dialysis (PD) is the preferred chronic dialysis modality for children suffring from chronic end-stage renal failure (CKD). But, it presents different infectious and non-infectious complications, causes of important morbidity and mortality. In this study, we aimed to describe the deferent infectious and mecanical complications observed in children on PD and to investigate the risk factors for the occurrence of different infectious and mechanical complications. Method In this study, we retrospectively collected the records of 99 patients who were treated with PD within the last eleven years (2010-2020) in the department of pediatrics of the University Hospital Charles Nicolle of Tunis. Analysis examining possible risque factors were performed using parametric and non-parametric tests and multivariate logistic regression in multivariate analysis. Results Ninety-nine children were on PD. All our patients were on automated PD. The sex ratio was 1.02. The overall duration of the PD was 290 years with an average of 2.93 years± 1.92 years. The average age at the beginning of PD was 9.75± 4.67 years. Sixty-nine patients had infectious complications, of which 65 patients had 120 episodes of peritonitis (IP) with a rate of 0.41 episodes per patient-year, 10 patients had exit-site infection and 3 patients had a tunnel infection. Mechanical complications were noted in 63 patients with a catheter revision rate of 1 per 38 patient-months. We noted an hernia in six patients, hemoperitoneum in seven patients, pancreatitis in three patients and no cases of hydrothorax. Analysis of PD complications risk revealed the following factors : poor adherence to treatment (p = 0.018 and p = 0.011) and weight less than 15 Kg (p = 0.041, p = 0.02) for infectious complications and IP respectively, comorbidity (p = 0.005) for mechanical complications, comorbidity (p = 0.008) and history of PI (p = 0.46) for catheter revision. Conclusion Ongoing educational programs for doctors, nurses and caregivers are needed to limit infectious complications. A collaboration between the pediatric nephrologist and the pediatric surgeon is recommended to improve catheter insertion techniques and prevent mechanical complications.