Continuous Ambulatory Peritoneal Dialysis (CAPO) in Children: A Clinical Report

Abstract

From January 1983 to January 1987, 18 children from 3.5 to 18 years of age (average 12.2 years) were treated by CAPD. Indications for CAPD were residence at a long distance from a hemodialysis center (8 cases); lack of vascular access (4 cases); need of frequent blood transfusions during hemodialysis (HD) treatment (3 cases); hypertension difficult to control (2 cases); cardio vascular insufficiency during hemodialysis treatment (2 cases); and emaciation (1 case). In some of the patients there was more than one indication. Twelve patients were on HD treatment for periods ranging from two months up to four years (average 14.3 months) prior to initiation of CAPD; one patient started CAPD after 2.5 months of intermittent peritoneal dialysis (IPD); for the remaining five patients, CAPD was the first form of dialysis. In 12 of 18 patients, there existed residual diuresis which was 8 ± 4 mL/kg/day on the average. CAPD was begun by inserting, under general anesthesia, a Tenckhoff or Oreopoulos silicone catheter , whose length was adjusted to the patient's height. The perforated part was fixed in the Douglas cavity, making sure that it was not positioned in the right iliac fossa to avoid close proximity to the appendix (2). The position of the catheter was checked with a radiograph before closure of the abdominal wall.