Continuous Ambulatory Peritoneal Dialysis in Children: Comparison with Hemodialysis

The clinical and biochemical effects of continuous ambulatory peritoneal dialysis in 20 children and of hemodialysis in 16 children were compared over a 2 1/2-year Period. Statistically significant differences between the treatment groups included higher hematocrit, higher serum carbon dioxide and cholesterol levels, larger intake of calories and protein, and lower systolic blood pressure and rates of transfusion in the patients receiving continuous ambulatory peritoneal dialysis. These patients had more complications than the patients receiving hemodialysis, but hospitalization rates in the two groups were similar. The cost of continuous ambulatory peritoneal dialysis was $19,600 per patient-year; the cost of hemodialysis was $54,300 per patient-year. There were four treatment failures with continuous ambulatory peritoneal dialysis and one with hemodialysis. Patients treated with both forms of dialysis preferred continuous ambulatory peritoneal dialysis. We conclude that continuous ambulatory peritoneal dialysis is an important alternative to hemodialysis in children. (N Engl J Med. 1982; 307:1537–42.), CONTINUOUS ambulatory peritoneal dialysis (ambulatory dialysis) was developed in 1975¹ but was not widely used until 1978, when the technique was adapted to the use of dialysate in plastic bags.² Children were first treated with ambulatory dialysis in Toronto in 1978,³ and many children have subsequently been treated in other centers. Although the reported experience with children is small, most authors^{4 5 6 7 8 9} have been enthusiastic, considering ambulatory dialysis at least as good as long-term hemodialysis for treatment of children with uremia. However, there have been no studies comparing the two types of dialysis in children. In this report we present our.