Effects of automated peritoneal dialysis on residual daily urinary volume in children.
2001
Preservation of residual renal function (RRF) is an important goal. In children, a more rapid decline in RRF has been observed under hemodialysis (HD) therapy as compared with
peritoneal dialysis(PD) therapy. In adults, however, automated
peritoneal dialysis(
APD) may cause a more rapid decline of RRF than
continuous ambulatory peritoneal dialysis(CAPD) does. The objective of the present study, a survey in a single center over the last 15 years, was to assess the impact of
APDversus hemodiafiltration (HDF) on daily urinary volume (dUV) outcome. We included 97 children who were dialyzed for at least a 12-month period between January 1985 and December 1999, using either HDF (n = 60; 62%) or PD [n = 37; 38% (86% of those on
APD)]. The endpoint was
anuriaoccurrence, defined as a dUV below 50 mL/m 2
body surface area(BSA) at three consecutive monthly determinations. Despite the use of HDF as hemodialysis therapy (that is, biocompatible membranes and a very low incidence of vascular instability during ultrafiltration), PD-even predominantly prescribed as
APD-was associated with better preservation of residual dUV. At
dialysisend,
anuriaoccurred in 65% of the children undergoing HD as compared with 23% of those undergoing PD. The mean age of the children at
dialysisstart was lower in the PD group. No other significant differences were noted between the groups, either for the rate of
uropathiesor for the RRF at initiation of
dialysis.
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