The role of APD in the management of pediatric patients: a report of the North American Pediatric Renal Transplant Cooperative Study.
In an attempt to delineate the role of automated peritoneal dialysis (APD) in the management of the pediatric patient with end-stage renal disease (ESRD), the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) dialysis registry database was queried concerning the incidence and outcome of APD compared to those enrolled who were undergoing continuous ambulatory peritoneal dialysis (CAPD). During the 10-year period from January 1, 1992 to January 1, 2002, 65% of the 4150 index dialysis patients enrolled in NAPRTCS underwent peritoneal dialysis (PD). APD was the dialysis modality of 69% of those choosing PD, indicating that APD was the primary dialysis modality for children during this time interval. This initial comparison of APD and CAPD from the NAPRTCS dialysis registry database indicated that there was a higher percentage of younger patients choosing APD, the time to transplantation was shorter for the CAPD patient, and the incidence and time to first peritonitis episode was significantly (p = 0.006) better in the APD population. There was no difference in the other parameters evaluated between the APD and CAPD patients. These data indicate the significant role of APD in the management of pediatric patients with ESRD, especially in infants, who frequently require an extended period of dialysis prior to reaching the eligibility criteria for transplantation.