SURGICAL COMPLICATIONS OF PERITONEAL DIALYSIS IN CHILDREN WITH CHRONIC KIDNEY FAILURE

Introduction. Peritoneal dialysis has a number of undeniable advantages in children with chronic renal failure (CRF). Despite widely used efforts to improve outcomes of peritoneal dialysis, its application is still limited by complications which are extremely common. Material and methods. 53 children with chronic renal failure who received peritoneal dialysis from 2003 to 2018 were taken into the study. Inclusion criteria were: diagnosed chronic renal failure, age (up to 18) and peritoneal dialysis. Results. Out of 53 children requiring peritoneal dialysis (PD), only 7 patients (13%) had no reported complications. Of 46 children with PD complications, 35 patients required surgical treatment under anesthesia. The most common complication in the first month of dialysis was dialysis peritonitis. 14 events per 12 patients (22.6%). Second place - pericatheter leaks (13.2%); bleeding at the catheter exit site - 6 (11.3%); inguinal hernia - 12 patients (22.6%); catheter dysfunction - 10 patients (19%). Infectious complications of peritoneal dialysis were registered in 34 patients (64%), of which 38% (13 patients) had concomitant non-infectious complications (leaks, dysfunction, tunnel hematoma). In our study, tissue infection (TI) was observed in 21 patient (40%); in 5 patients (25% of all TI), it was associated with dialysis peritonitis. There were 93 peritonitis cases . Conclusion. The increasing number of children with renal pathology requiring renal replacement therapy makes dialysis specialists (nephrologists, surgeons) face new tasks to reduce the number of complications and prolong the life of such patients.

peritoneal dialysis, complications of peritoneal dialysis, nephrology, pediatric surgery, chronic renal failure