Abstract

Aim: Chrortic peritoneal dialysis (CPD) is an important choice of renal replacement therapy in children. Despite technical advances, catheter-related mechanical complications are still prominent and can lead to morbidity and mortality. The aim of this retrospective study is to share our ten-year clinical experience on catheter-related mechanical complications in children whose catheters were placed by percutaneous route. Methods: This study was carried out on in 93 patients (48 boys, 45 girls), with a mean age of 9.03 ± 4.51 years, during the period betvueen Nouember 1995 and December 2005. Mean follow-up period of patients was 28.7±23.5 months. Catheter insertion age ranged between 4 months and 16 years (mean: 9.1 ± 4.3 years). 108 peritoneal catheters implanted by percutaneous route were Tenckhoff swan-neck double-cuff pediatric catheters and were all implanted by a nephrologist in our unit. Patients were evaluated in 4 groups (<2 years, 3-5 years, 6-10 years and >10 years) in terms of age of catheter implantation, catheter placement status (urgent or elective), catheter and patient survival and catheter-related mechanical complications. Statistical analysis was made by Anova, Chi-square and Kaplan-Meier methods. P<0.05 were accepted as statistically important. Results: Mean catheter observation period and patient survival were 81.03 ±6.1 months and 75 months (range: 10 days-109 months), respectively. Complications were drainage failure in 6, catheter dislocation in 3, kink in 2 and omental adjustment in 2 catheters. There was no statistical differenee between catheter-related mechanical complications and either age groups or catheter placement status (p>0.05). Due to mechanical complications, reimplantation was performed in 15 (13.8%) out of 108 catheters (laparoscopic intervention in 3, open surgery in 9, percutaneous reimplantion in 3). Corıclusion: Although mechanical complications are encountered in CPD, when performed by experienced nephrologists percutaneous placement of peritoneal dialysis catheters is an easy and effective method in childhood.