Risk factors for catheter-related complications in pediatric peritoneal dialysis.

ABSTRACT

Catheter-related complications, including infection, dialysate leak, and malfunction, are the principal causes of peritoneal dialysis (PD) failure. To determine risk factors predisposing to these complications, we conducted a retrospective study of 90 children on chronic PD who received 127 catheters from January 1990 to December 2000. There was a significant risk for dialysate leak when PD catheters were used early (14 days). There was no significant difference in malfunction and infection rate between early and delayed use groups. Weight and height <5th percentile, low serum albumin, and history of abdominal surgery were not associated with an increased risk of complications. History of dialysis prior to catheter placement and presence of a gastrostomy tube (G-tube) were both associated with significant infection risk. Patients risk of infection. We conclude that delayed use of the PD catheter led to a lower incidence of dialysate leak but had no effect on infection rate. Young age, G-tube, and history of prior dialysis are risk factors for infection. Multi-center, prospective controlled studies involving larger numbers of children are important to confirm these findings.