Аннотация
INTRODUCTION AND AIMS: Peritoneal dialysis was launched in Kazakhstan in 2009 and remains the preferred method of dialysis for children with end-stage renal disease in conditions when kidney transplantation cannot be performed. The purpose of this research was to analyze peritoneal dialysis (PD) catheter survival and causes of PD catheter removal in children with end-stage renal disease. METHODS: Data from pediatric patients who were admitted to National Research Center for Maternal and Child Health between November 1, 2009 and December 12, 2014 and underwent PD catheter placement were reviewed retrospectively. Outcomes were catheter life, early (within the first 30 days after placement) and late (> 30 days after placement) complications (pericatheter leak, catheter malfunction and malposition, and infection), which required permanent or temporal catheter removal. All pediatric patients were divided according to their age in two groups: children older than 2 years of age (Group 1) and younger (Group 2). RESULTS: The overall 44 pediatric patients underwent 54 PD catheters placement using open technique in all cases. Partial omentectomy was performed in 53 cases. 47 PD catheters were placed in Group 1 with an average patient age of 11.7 ± 6.1 years and 7 placements were performed in Group 2 with an average patient age of 11.6 ± 7.6 months. The difference in mean catheter life in both groups was not significant (1223.97 ± 130.7 days in Group 1 versus 1483.5 ± 209.5 days in Group 2, p = 0.31). In 14 patients (29.8%) of Group 1 and in 1 patient (14.3%) of Group 2 catheters were removed (re-operation rate 27.7% for both groups). Early complications, which led to catheter removal, were observed only in 2 cases (14%) in Group 1 (catheter malfunction due to omentum obstruction in a patient without omentectomy and another one case with pericatheter leak). Late causes of PD catheter removal in Group 1 included: resistant peritonitis in 57% (8 cases), tunnel infection in 14% (2 cases), catheter malfunction in 7% (1 case) and late pericatheter leak in 7% (1 case). In Group 2 the only one incident of catheter removal was due to peritonitis. CONCLUSIONS: Open technique of PD catheter placement can be safe with re-operation rate of 27.7% and 86% of one-year survival rate. The most common cause of PD catheter removal in our study was peritonitis.