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Chronic peritoneal dialysis in children

Annabelle Chua, MD
Bradley A Warady, MD
Section Editor
Patrick Niaudet, MD
Deputy Editor
Melanie S Kim, MD


Chronic peritoneal dialysis (CPD) is the most common dialysis treatment modality used to treat pediatric patients with end-stage renal disease (ESRD), particularly in children less than five years of age [1-3]. CPD offers several advantages over hemodialysis (HD) that are beneficial for children; however, there are clinical settings in which CPD is contraindicated or may not be the best dialytic modality. In addition, although the principles of CPD are the same for pediatric and adult patients, there are aspects of CPD that are unique to children and infants, which need to be addressed to ensure the adequacy of dialysis and to reduce complications for the pediatric patient.

The various aspects of chronic peritoneal dialysis in children will be reviewed here. Overview of renal replacement therapy (RRT) in children and hemodialysis for children with chronic kidney disease are presented separately. (See "Overview of renal replacement therapy (RRT) for children with chronic kidney disease" and "Hemodialysis for children with chronic kidney disease".)

The general mechanisms of the removal of solute and fluid during CPD are the same in the adult and pediatric patient and are also discussed separately. (See "Mechanisms of solute clearance and ultrafiltration in peritoneal dialysis".)


There have not been any comparative studies of peritoneal dialysis (PD) and hemodialysis (HD) outcomes in children with end-stage renal disease (ESRD) to suggest superiority of one procedure versus the other. While the majority of pediatric patients with ESRD who require dialysis can be managed with CPD, the choice of dialysis modality is most often based on patient and family preference, center philosophy, and availability of the desired modality.

The quality of life for both patient and family assumes great importance in the selection of home dialysis therapy as a result of the "burden of care" associated with this approach to ESRD management. As such, careful evaluation of the family's social, psychological, and economic background, ideally by a multiprofessional team including the family clinician and nephrologist, dialysis nurse, psychologist, and social worker, is mandatory if a fully informed decision regarding modality selection is to be made [4,5].

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Literature review current through: Nov 2017. | This topic last updated: Feb 23, 2016.
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