Peritoneal dialysis following open heart surgery in children

Abstract

Over the course of the last 5 years, we have instituted peritoneal dialysis on 26 (7.7%) of 338 complex postoperative cardiac bypass cases. The mean age of dialysis patients was 0.64±0.75 years with a range of 0.1–2.5 years. The indications for the start of dialysis were oliguria (15 cases), fluid overload (three cases), hyperkalemia (one case), and anuria (seven cases). There were no complications as the result of dialysis, although two of the dialysis catheters had to be replaced. Dialysis successfully treated the starting indication in all cases. Dialysis was instituted at 47±50 (12–240) h after bypass, and lasted 111±134 (18–552) h; early institution of dialysis had no effect on mortality. Low cardiac output was a significant predictor of death in dialysis patients (p=0.015). Age was a significant determinant of death (p=0.0001) and the need for dialysis (p=0.0043) in the total bypass population; the younger the patient, the greater was the likelihood of death or the need for dialysis. Age, however, was not a predictor of mortality in the peritoneal dialysis group.