Fisvush B, Furth S, Hwang W, Neu A, Powe N
Peritoneal vs hemodialysis for children at centers specializing
in pediatric vs adult care
XVIth Annual CAPD Conference
Perit Dial Int Suppl 2
(Feb) 16:S91 1996
This study examined choice of modality (PD vs HD) for pediatric patients in
various dialysis
facilities as a function of the percent pediatric patients (defined as those
<19 years of age)
being treated at the facility. 1990 Medicare data were used for the study.
When <5% of patients at a facility were < 19 years old, such
patients were more likely to receive hemodialysis than PD. In contrast, when
the "pediatric"
patient percentage was greater than 10%, pediatric patients were more likely
to receive PD. Only
29% of pediatric patients were dialyzed in "specialized" facilities, i.e.,
those having more than
10% pediatric patients. These figures were adjusted for age, race,
education, ESRD cause and
duration, etc.
Comment: This is an interesting study which confirms a general
perception that CAPD is used
in pediatric patients more than in adults. PD offers several advantages to
children with end-stage
renal disease, particularly nutritional advantages, parental cooperation and
home delivery. It is
interesting that the odds ratio of "choosing" PD vs HD is even when the %
pediatric patients is
<1%, and increases to 1.56 in the more specialized facilities.
(James L. Winchester, M.D.)
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XVIth Annual CAPD Conference
CRF by problem area :
CRF in infants and children