{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:02:30Z","timestamp":1791579750027,"version":"4.3.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2017,1]]},"abstract":"\n Background and objectives<\/jats:title>\n Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95;\n P<\/jats:italic>\n <0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59;\n P<\/jats:italic>\n =0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87;\n P<\/jats:italic>\n =0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63;\n P<\/jats:italic>\n =0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19;\n P<\/jats:italic>\n =0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65;\n P<\/jats:italic>\n =0.003). Access dysfunction due to mechanical causes doubled the risk of technique failure compared with infectious causes (hazard ratio, 1.95; 95% confidence interval, 1.20 to 2.30;\n P<\/jats:italic>\n =0.03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Peritoneal dialysis catheter revisions are common in pediatric patients on peritoneal dialysis and complicate provision of chronic peritoneal dialysis. Attention to potentially modifiable risk factors by pediatric nephrologists and pediatric surgeons should be encouraged.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.05270516","type":"journal-article","created":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T23:30:19Z","timestamp":1480462219000},"page":"105-112","source":"Crossref","is-referenced-by-count":68,"title":["Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes"],"prefix":"10.2215","volume":"12","author":[{"given":"Dagmara","family":"Borzych-Duzalka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Fazil","family":"Aki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Azocar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevgi","family":"Mir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Adragna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erkin","family":"Serdaroglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Samaille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jose","family":"Vanegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameela","family":"Kari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Barbosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Bagga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Galanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onder","family":"Yavascan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Leozappa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Szczepanska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Vondrak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei-Chiu","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Schaefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Warady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the International Pediatric Peritoneal Dialysis Network (IPPN) Registry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,11,29]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1038\/nrneph.2011.135","article-title":"Peritoneal dialysis in children with end-stage renal disease.","volume":"7","author":"Schaefer","year":"2011","journal-title":"Nat Rev Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000093595","article-title":"Peritoneal access: The past, present, and the future.","volume":"150","author":"Twardowski","year":"2006","journal-title":"Contrib Nephrol"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s00383-006-1685-9","article-title":"Chronic peritoneal dialysis in children: Catheter related complications. A single centre experience.","volume":"22","author":"Macchini","year":"2006","journal-title":"Pediatr Surg Int"},{"key":"B7-20230813","first-page":"274","article-title":"A comparison of double-cuffed with single-cuffed Tenckhoff catheters in the prevention of infection in pediatric patients.","volume":"13","author":"Lewis","year":"1997","journal-title":"Adv Perit Dial"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/0022-3468(86)90033-3","article-title":"Surgical management of peritoneal dialysis catheters in children: Five-year experience with 1,800 patient-month follow-up.","volume":"21","author":"Stone","year":"1986","journal-title":"J Pediatr Surg"},{"key":"B9-20230813","first-page":"24","article-title":"The outcome of Iranian children on continuous ambulatory peritoneal dialysis: The first report of Iranian National Registry.","volume":"12","author":"Hooman","year":"2009","journal-title":"Arch Iran Med"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s004649901198","article-title":"Primary laparoscopic placement of peritoneal dialysis catheters in children and young adults.","volume":"13","author":"Lessin","year":"1999","journal-title":"Surg Endosc"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.jpedsurg.2009.06.019","article-title":"Risk factors for early peritoneal dialysis catheter failure in children.","volume":"45","author":"Cribbs","year":"2010","journal-title":"J Pediatr Surg"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1093\/ndt\/17.9.1564","article-title":"Management of the infant with end-stage renal failure.","volume":"17","author":"Rees","year":"2002","journal-title":"Nephrol Dial Transplant"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1093\/ndt\/gfn035","article-title":"Peritoneal dialysis in children under two years of age.","volume":"23","author":"Laakkonen","year":"2008","journal-title":"Nephrol Dial Transplant"},{"issue":"Suppl 2","key":"B14-20230813","doi-asserted-by":"crossref","first-page":"S473","DOI":"10.1177\/089686089901902S78","article-title":"The 1997 Report of the Japanese National Registry data on pediatric peritoneal dialysis patients.","volume":"19","author":"Honda","year":"1999","journal-title":"Perit Dial Int"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/00008480-199604000-00009","article-title":"An update on peritoneal dialysis and hemodialysis in the pediatric population.","volume":"8","author":"Warady","year":"1996","journal-title":"Curr Opin Pediatr"},{"key":"B16-20230813","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1053\/jpsu.2000.18303","article-title":"Surgical aspects of dialysis in newborns and infants weighing less than ten kilograms.","volume":"35","author":"Beanes","year":"2000","journal-title":"J Pediatr Surg"},{"key":"B17-20230813","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jpedsurg.2016.02.011","article-title":"Outcomes after peritoneal dialysis catheter placement.","volume":"51","author":"Carpenter","year":"2016","journal-title":"J Pediatr Surg"},{"key":"B18-20230813","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/j.jpedsurg.2015.12.005","article-title":"Surgical complications after peritoneal dialysis catheter implantation depend on children\u2019s weight.","volume":"51","author":"Radtke","year":"2015","journal-title":"J Pediatr Surg"},{"key":"B19-20230813","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3747\/pdi.2012.00126","article-title":"Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: Insights from the International Pediatric Peritoneal Dialysis Network Registry.","volume":"32","author":"Schaefer","year":"2012","journal-title":"Perit Dial Int"},{"key":"B20-20230813","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jpedsurg.2012.10.035","article-title":"Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters.","volume":"48","author":"Phan","year":"2013","journal-title":"J Pediatr Surg"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3747\/pdi.2008.00278","article-title":"Outcome and risk factors for mortality in pediatric peritoneal dialysis.","volume":"30","author":"Tsai","year":"2010","journal-title":"Perit Dial Int"},{"key":"B22-20230813","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1007\/s00467-004-1520-2","article-title":"Risk factors for catheter-related complications in pediatric peritoneal dialysis.","volume":"19","author":"Rahim","year":"2004","journal-title":"Pediatr Nephrol"},{"key":"B23-20230813","first-page":"318","article-title":"Chest wall peritoneal dialysis catheter placement in infants with a colostomy.","volume":"16","author":"Chadha","year":"2000","journal-title":"Adv Perit Dial"},{"key":"B25-20230813","first-page":"47","article-title":"The role of peritoneal dialysis catheter configuration in preventing catheter tip migration.","volume":"16","author":"Gadallah","year":"2000","journal-title":"Adv Perit Dial"},{"key":"B26-20230813","first-page":"124","article-title":"Mechanical complications in chronic peritoneal dialysis.","volume":"52","author":"Moreiras Plaza","year":"1999","journal-title":"Clin Nephrol"},{"key":"B27-20230813","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.2215\/CJN.05150709","article-title":"Relapsing peritonitis in children who undergo chronic peritoneal dialysis: A prospective study of the international pediatric peritonitis registry.","volume":"5","author":"Lane","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"B28-20230813","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1053\/j.ajkd.2007.11.011","article-title":"Gram-negative peritonitis in children undergoing long-term peritoneal dialysis.","volume":"51","author":"Zurowska","year":"2008","journal-title":"Am J Kidney Dis"},{"issue":"Suppl 2","key":"B29-20230813","doi-asserted-by":"crossref","first-page":"S127","DOI":"10.1177\/089686080302302s26","article-title":"A prospective randomized study on three different peritoneal dialysis catheters.","volume":"23","author":"Lo","year":"2003","journal-title":"Perit Dial Int"},{"key":"B31-20230813","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1038\/ki.2013.365","article-title":"A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival.","volume":"85","author":"Hagen","year":"2014","journal-title":"Kidney Int"},{"issue":"Suppl 2","key":"B32-20230813","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3747\/pdi.2011.00091","article-title":"Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update.","volume":"32","author":"Warady","year":"2012","journal-title":"Perit Dial Int"},{"key":"B33-20230813","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S1051-0443(97)70693-6","article-title":"Guide wire directed manipulation of malfunctioning peritoneal dialysis catheters: A critical analysis.","volume":"8","author":"Savader","year":"1997","journal-title":"J Vasc Interv Radiol"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/S0272-6386(99)70266-0","article-title":"Peritoneoscopic versus surgical placement of peritoneal dialysis catheters: A prospective randomized study on outcome.","volume":"33","author":"Gadallah","year":"1999","journal-title":"Am J Kidney Dis"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/SLE.0000000000000188","article-title":"The survival and complication rates of laparoscopic versus open catheter placement in peritoneal dialysis patients: A meta-analysis.","volume":"25","author":"Chen","year":"2015","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B38-20230813","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.urology.2006.12.033","article-title":"Laparoscopic-assisted peritoneal dialysis catheter implantation in pediatric patients.","volume":"69","author":"Mattioli","year":"2007","journal-title":"Urology"},{"key":"B39-20230813","first-page":"218","article-title":"Surgical technique for peritoneal dialysis catheter placement in the pediatric patient: A North American survey.","volume":"20","author":"Washburn","year":"2004","journal-title":"Adv Perit Dial"},{"key":"B40-20230813","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/S0022-5347(01)67203-3","article-title":"Minimizing surgical problems of peritoneal dialysis in children.","volume":"154","author":"Conlin","year":"1995","journal-title":"J Urol"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201701000-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:36:24Z","timestamp":1786368984000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201701000-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,29]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.05270516","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,29]]}}}