Gravity-assisted continuous flow peritoneal dialysis technique use in acute kidney injury in children: a randomized, crossover clinical trial.
Background: Our previously demonstrated continuous flow peritoneal dialysis (CFPD) technique in children with acute kidney injury (AKI), although effective, was manpower heavy and expensive due to the high-volume pumps required. The aim of this study was to develop and test a novel gravity-driven CF...
| Publicado en: | Pediatric Nephrology Vol. 38; no. 8; pp. 2781 - 2791 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Springer Nature
Aug2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=169702882&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 169702882 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Aug2023 vid: 38 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 169702882 162458517 169702882 169702882 10.1007/s00467-022-05852-3 169702882 ppf: 2781 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Gravity-assisted continuous flow peritoneal dialysis technique use in acute kidney injury in children: a randomized, crossover clinical trial. aug: au: Nourse, Peter McCulloch, Mignon Coetzee, Ashton Bunchman, Tim Picca, Stefano Rusch, Jody Brooks, Andre Heydenrych, Hilton Morrow, Brenda affil: Division of Pediatric Nephrology, Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa sug: subj: Kidney Failure, Acute Therapy Peritoneal Dialysis Methods Peritoneal Dialysis, Continuous Ambulatory Economics Treatment Outcomes Evaluation Health Care Costs Human Child Randomized Controlled Trials Crossover Design Random Assignment Dialysis Patients Pilot Studies Paired T-Tests Descriptive Statistics Peritoneal Dialysis, Continuous Ambulatory Adverse Effects Urea Blood Creatinine Blood Phosphates Blood Child: 6-12 years ab: Background: Our previously demonstrated continuous flow peritoneal dialysis (CFPD) technique in children with acute kidney injury (AKI), although effective, was manpower heavy and expensive due to the high-volume pumps required. The aim of this study was to develop and test a novel gravity-driven CFPD technique in children using readily available, inexpensive equipment and to compare this technique to conventional PD. Methods: After development and initial in vitro testing, a randomised crossover clinical trial was conducted in 15 children with AKI requiring dialysis. Patients received both conventional PD and CFPD sequentially, in random order. Primary outcomes were measures of feasibility, clearance and ultrafiltration (UF). Secondary outcomes were complications and mass transfer coefficients (MTC). Paired t-tests were used to compare PD and CFPD outcomes. Results: Median (range) age and weight of participants were 6.0 (0.2–14) months and 5.8 (2.3–14.0) kg, respectively. The CFPD system was easily and rapidly assembled. There were no serious adverse events attributed to CFPD. Mean ± SD UF was significantly higher on CFPD compared to conventional PD (4.3 ± 3.15 ml/kg/h vs. 1.04 ± 1.72 ml/kg/h; p < 0.001). Clearances for urea, creatinine and phosphate for children on CFPD were 9.9 ± 3.10 ml/min/1.73 m2, 7.9 ± 3.3 ml/min/1.73 m2 and 5.5 ± 1.5 ml/min/1.73 m2 compared to conventional PD with values of 4.3 ± 1.68 ml/min/1.73 m2, 3.57 ± 1.3 ml/min/1.73 m2 and 2.53 ± 0.85 ml/min/1.73 m2, respectively (all p < 0.001). Conclusion: Gravity-assisted CFPD appears to be a feasible and effective way to augment ultrafiltration and clearances in children with AKI. It can be assembled from readily available non-expensive equipment. pubtype: Academic Journal doctype: pictorial research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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