Clinical and Dialysis Outcomes of Manual Chronic Peritoneal Dialysis in Low-body-weight Children from a Low-to-middle-income Country

Background: Peritoneal dialysis (PD) is the preferred modality of renal replacement therapy in children with end-stage renal disease (ESRD). In developing countries, the challenges of initiating and sustaining chronic peritoneal dialysis (CPD) are many and are not well-described in the literature.

Methods: This was a retrospective study of children aged 0-18 years on manual PD. The objective was to compare the clinical (growth) and dialysis outcomes (dialysis adequacy and peritonitis rates) in young children with low body weight (LBW; ≤15 kg) on CPD with children weighing >15 kg.

Results: We found that at baseline, the dialysis prescription, sociodemographic parameters, and the prevalence of complications of ESRD were similar in both groups. On follow-up, however, growth was significantly more affected in LBW children than the rest of the cohort. The adequacy of dialysis and peritonitis rates were comparable between groups.

Conclusions: Despite all the challenges, manual CPD is a feasible modality of dialysis in young children with LBW, and their outcomes are comparable to older children even in low-to-middle-income countries. Appropriate early management of associated complications and improving dialysis adequacy are necessary to improve the outcomes in these children.