Outcomes of Pediatric Peritoneal Dialysis Care in Srinagarind Hospital Between 2017 to 2022
Keywords:
peritoneal dialysis care, pediatric, end stage kidney diseaseAbstract
Background and Objectives: Pediatric patients undergoing peritoneal dialysis represent a complex group requiring specialized care to minimize complications and enhance survival rates. This study aimed to evaluate the outcomes of pediatric peritoneal dialysis care at Srinagarind Hospital.
Methods: A retrospective study was conducted using medical records, care documentation, and information systems. The sample included medical records of pediatric patients first diagnosed with end-stage renal disease and treated with peritoneal dialysis, aged < 18 years, who received care at the pediatric dialysis clinic of Srinagarind Hospital between January 1st, 2017, and December 31st, 2022. Data were analyed by comparinged outcomes of two time periods: 2017-2020 and 2021-2022, focusing on patient survival rates and complications.
Results: The sample included 22 pediatric patients undergoing peritoneal dialysis, with 15 patients from the period 2017-2020 and 7 patients from the period 2021-2022, with a mean age of 10.61 ± 4.71 years. The leading cause of end-stage renal disease was lupus nephritis, accounting for 22.73% of cases. The one-year survival rate was 93.33% for the period of 2017-2020, which was not statistically different from the 85.71% in 2021-2022. However However, incidence of peritonitis decreased from 0.67 episodes per patient per year during 2017 - 2022 to 0.24 episodes per patient per year during 2021 - 2022.. There were no occurrences of exit-site infections in 2021-2022, down from an incidence of 0.22 episodes per patient per year in 2017-2020. The rate reductions of both peritonitis and exit-site infections were not statistically significant. In the years 2021-2022, no instances of volume overload were observed, and only a single occurrence of catheter displacement, occlusion, or rupture was reported.
Conclusion: The incidence of peritonitis serves as a critical indicator of care quality in pediatric peritoneal dialysis. This study demonstrates an improvement in both the rates of peritonitis and catheter-related infections during the period of 2021-2022 compared to 2017-2020, attributed to advancements in the management of pediatric patients undergoing peritoneal dialysis.
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