Thirty-one infants and children with acute failure were treated with
peritoneal dialysis using a surgically placed Tenckhoff
catheter. In 10 patients a
peritoneal dialysis cycler was used, and 21 were dialyzed by the manual method. Initially, hourly exchanges were given for 24 to 48 h and, as the patients stabilized, 10 exchanges per day at 1-h intervals were given. The mean stabilization period was 36 +/- 8 h. The predialysis mean serum
creatinine was 5.8 +/- 1.8 mg% and the serum
creatinine while on daily dialysis was 2.8 +/- 1.1 mg%.
Peritoneal dialysis succeeded in controlling metabolic abnormalities and improving fluid balance. All the
catheters except one functioned immediately following insertion. Median duration of
catheter placement for dialysis was 18 days (range 2 to 90). The incidence of
peritonitis was 12.8%, and exit site
infection was 6.4%. The
infection rate was decreased when a cycler was used compared with the manual method (23.8% vs. 10.0%), though not statistically significant. Two patients developed
hypothermia while being dialyzed via the manual method. To conclude, 10 daily
peritoneal dialysis exchanges performed at 1-h intervals after initial stabilization using a surgically placed Tenckhoff
catheter is an effective and safe mode of dialytic
therapy for children with
acute renal failure. Complications (
infection and
hypothermia) are reduced with the use of a cycler.