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Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis: a survey from the European Paediatric Dialysis Working Group

(2015) PEDIATRIC NEPHROLOGY. 30(11). p.2021-2027
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Abstract
Pleural or pericardial effusions secondary to pleuro-peritoneal fistula (PPF) and pericardio-peritoneal fistula (PcPF) are rare but serious complications of peritoneal dialysis (PD). We conducted a 10-year survey across all participating centres in the European Paediatric Dialysis Working Group to review the incidence, diagnostic techniques, therapeutic options and outcome of children on chronic PD with PPF and/or PcPF. Of 1506 children on PD there were ten cases (8 of PPF, 1 each of PcPF and PPF + PcPF), with a prevalence of 0.66 %. The median age at presentation was 1.5 [inter-quartile range (IQR) 0.4-2.4] years, and nine children were < 3 years. The time on PD before onset of symptoms was 4.3 (IQR 1.3-19.8) months. Eight children had herniae and seven had abdominal surgery in the preceding 4 weeks. Symptoms at presentation were respiratory distress, reduced ultrafiltration and tachycardia. PD was stopped in all children; three were managed conservatively and thoracocentesis was performed in seven (with pleurodesis in 3). PD was restarted in only three children, in two of them with success. In conclusion, PPF and PcPF are rare in children on chronic PD, but are associated with significant morbidity, requiring a change of dialysis modality in all cases. Risk factors for PPF development include age of < 3 years, herniae and recent abdominal surgery.
Keywords
Pleuro-peritoneal fistula, Peritoneal dialysis, Pericardio-peritoneal fistula, Children, Pleural effusion, Pericardial effusion, HYDROTHORAX COMPLICATING PERITONEAL, PLEUROPERITONEAL COMMUNICATION, INTRAPERITONEAL PRESSURE, MANAGEMENT, PATIENT, DEFECTS, OPTIONS, INFANT, VOLUME, CAPD

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MLA
Dufek, Stephanie et al. “Pleuro-peritoneal or Pericardio-peritoneal Leak in Children on Chronic Peritoneal Dialysis: a Survey from the European Paediatric Dialysis Working Group.” PEDIATRIC NEPHROLOGY 30.11 (2015): 2021–2027. Print.
APA
Dufek, S., Holtta, T., Fischbach, M., Ariceta, G., Jankauskiene, A., Cerkauskiene, R., Schmitt, C. P., et al. (2015). Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis: a survey from the European Paediatric Dialysis Working Group. PEDIATRIC NEPHROLOGY, 30(11), 2021–2027.
Chicago author-date
Dufek, Stephanie, Tuula Holtta, Michel Fischbach, Gema Ariceta, Augustina Jankauskiene, Rimante Cerkauskiene, Claus Peter Schmitt, et al. 2015. “Pleuro-peritoneal or Pericardio-peritoneal Leak in Children on Chronic Peritoneal Dialysis: a Survey from the European Paediatric Dialysis Working Group.” Pediatric Nephrology 30 (11): 2021–2027.
Chicago author-date (all authors)
Dufek, Stephanie, Tuula Holtta, Michel Fischbach, Gema Ariceta, Augustina Jankauskiene, Rimante Cerkauskiene, Claus Peter Schmitt, Betti Schaefer, Christoph Aufricht, Elizabeth Wright, Constantinos J Stefanidis, Mesiha Ekim, Sevcan Bakkaloglu, Günter Klaus, Aleksandra Zurowska, Karel Vondrak, Johan Vande Walle, Alberto Edefonti, and Rukshana Shroff. 2015. “Pleuro-peritoneal or Pericardio-peritoneal Leak in Children on Chronic Peritoneal Dialysis: a Survey from the European Paediatric Dialysis Working Group.” Pediatric Nephrology 30 (11): 2021–2027.
Vancouver
1.
Dufek S, Holtta T, Fischbach M, Ariceta G, Jankauskiene A, Cerkauskiene R, et al. Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis: a survey from the European Paediatric Dialysis Working Group. PEDIATRIC NEPHROLOGY. 2015;30(11):2021–7.
IEEE
[1]
S. Dufek et al., “Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis: a survey from the European Paediatric Dialysis Working Group,” PEDIATRIC NEPHROLOGY, vol. 30, no. 11, pp. 2021–2027, 2015.
@article{6897404,
  abstract     = {Pleural or pericardial effusions secondary to pleuro-peritoneal fistula (PPF) and pericardio-peritoneal fistula (PcPF) are rare but serious complications of peritoneal dialysis (PD). 
We conducted a 10-year survey across all participating centres in the European Paediatric Dialysis Working Group to review the incidence, diagnostic techniques, therapeutic options and outcome of children on chronic PD with PPF and/or PcPF. 
Of 1506 children on PD there were ten cases (8 of PPF, 1 each of PcPF and PPF + PcPF), with a prevalence of 0.66 %. The median age at presentation was 1.5 [inter-quartile range (IQR) 0.4-2.4] years, and nine children were < 3 years. The time on PD before onset of symptoms was 4.3 (IQR 1.3-19.8) months. Eight children had herniae and seven had abdominal surgery in the preceding 4 weeks. Symptoms at presentation were respiratory distress, reduced ultrafiltration and tachycardia. PD was stopped in all children; three were managed conservatively and thoracocentesis was performed in seven (with pleurodesis in 3). PD was restarted in only three children, in two of them with success. 
In conclusion, PPF and PcPF are rare in children on chronic PD, but are associated with significant morbidity, requiring a change of dialysis modality in all cases. Risk factors for PPF development include age of < 3 years, herniae and recent abdominal surgery.},
  author       = {Dufek, Stephanie and Holtta, Tuula and Fischbach, Michel and Ariceta, Gema and Jankauskiene, Augustina and Cerkauskiene, Rimante and Schmitt, Claus Peter and Schaefer, Betti and Aufricht, Christoph and Wright, Elizabeth and Stefanidis, Constantinos J and Ekim, Mesiha and Bakkaloglu, Sevcan and Klaus, Günter and Zurowska, Aleksandra and Vondrak, Karel and Vande Walle, Johan and Edefonti, Alberto and Shroff, Rukshana},
  issn         = {0931-041X},
  journal      = {PEDIATRIC NEPHROLOGY},
  keywords     = {Pleuro-peritoneal fistula,Peritoneal dialysis,Pericardio-peritoneal fistula,Children,Pleural effusion,Pericardial effusion,HYDROTHORAX COMPLICATING PERITONEAL,PLEUROPERITONEAL COMMUNICATION,INTRAPERITONEAL PRESSURE,MANAGEMENT,PATIENT,DEFECTS,OPTIONS,INFANT,VOLUME,CAPD},
  language     = {eng},
  number       = {11},
  pages        = {2021--2027},
  title        = {Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis: a survey from the European Paediatric Dialysis Working Group},
  url          = {http://dx.doi.org/10.1007/s00467-015-3137-z},
  volume       = {30},
  year         = {2015},
}

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