TIDAL PERITONEAL-DIALYSIS IN CHILDREN - INITIAL EXPERIENCES

This trial was conducted to determine whether tidal peritoneal dialysis (TPD) could be used at home, reduce dialysis time, and provide clearances equal those of continuous cyclic peritoneal dialysis (CCPD). Six children ages 5-16, followed at the University of Iowa Hospitals and Clinics, used an automated cycler to perform TPD. Dialysis sessions were limited to 8 hours and daytime dwell volumes minimized Dialysate urea, total nitrogen and creatinine losses were measured, and dialysis was adjusted to provide therapy equal to the patients' earlier CCPD. After 6 months of treatment, the children and their parents were interviewed to determine their satisfaction or reservations with TPD. The subjects and their parents uniformly felt comfortable performing TPD at home and preferred tidal dialysis to CCPD because the shorter dialysis allow more time for family and after-school activities. TPD attained creatinine and urea removal equal that of CCPD, but only when dialysate flow exceeded 40 ml/kg/Hr. Using higher dialysate flow rates increased the total quantity of dialysate used for dialysis (9 liters/CCPD, 16 liters/TPD), but did not induce dialysis discomfort.