Abstract
Background: Peritonitis is a severe complication of chronic peritoneal dialysis (CPD) in infants. Few studies have been conducted to evaluate the relationship between hypogammaglobulinemia and peritonitis risk, and the potential benefit of intravenous immunoglobulins (IVIG) therapy in infants receiving CPD. Methods: Patients aged 0–12 months at initiation of CPD between 1985 and 2012 were eligible for inclusion in this retrospective study. Data collected from the start of CPD up to 2 years post-dialysis initiation included patient demographics, dialysis characteristics, serum immunoglobulin (IgG) levels, IVIG administration history, infectious complications and outcomes. Cox regression analysis and linear mixed model analysis were used for statistical analysis. Results: Twenty-six consecutive patients were included in the study. Annualized peritonitis rates for infants aged 0–30 days (≤1-month age group; n = 16; 320.3 patient-months) and 31–365 days (>1–12-month age group; n = 10; 163.3 patient-months) at dialysis initiation were 0.27 (1 episode per 45.8 patient-months) and 0.15 (one episode per 81.7 patient-months), respectively. Seventy-six percent of the serum IgG levels were >1 standard deviation below the age-appropriate mean levels, and these did not differ in those who developed peritonitis versus those who did not (p = 0.39). Serum IgG levels were significantly lower in patients on CPD with oligoanuria than in non-oliguric patients (p = 0.04) and in patients on CPD for >90 days as compared to those who had received CPD for <90 days (p = 0.018). IVIG therapy was provided to 20 patients with hypogammaglobulinemia; this high prevalence of IVIG usage precluded any drawing of conclusion on the potential role of IVIG in the prevention of peritonitis. Conclusions: Hypogammaglobulinemia is a frequent complication of CPD during infancy. In our experience, it was not associated with an increased risk for peritonitis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 503-509 |
| Number of pages | 7 |
| Journal | Pediatric Nephrology |
| Volume | 32 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2017 |
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Keywords
- Hypogammaglobulinemia
- Immunoglobulin
- Infant dialysis
- Neonates
- Peritoneal dialysis
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nephrology
Cite this
Hypogammaglobulinemia in infants receiving chronic peritoneal dialysis. / Lalan, Shwetal; Dai, Hongying; Warady, Bradley A.
In: Pediatric Nephrology, Vol. 32, No. 3, 01.03.2017, p. 503-509.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypogammaglobulinemia in infants receiving chronic peritoneal dialysis
AU - Lalan, Shwetal
AU - Dai, Hongying
AU - Warady, Bradley A.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: Peritonitis is a severe complication of chronic peritoneal dialysis (CPD) in infants. Few studies have been conducted to evaluate the relationship between hypogammaglobulinemia and peritonitis risk, and the potential benefit of intravenous immunoglobulins (IVIG) therapy in infants receiving CPD. Methods: Patients aged 0–12 months at initiation of CPD between 1985 and 2012 were eligible for inclusion in this retrospective study. Data collected from the start of CPD up to 2 years post-dialysis initiation included patient demographics, dialysis characteristics, serum immunoglobulin (IgG) levels, IVIG administration history, infectious complications and outcomes. Cox regression analysis and linear mixed model analysis were used for statistical analysis. Results: Twenty-six consecutive patients were included in the study. Annualized peritonitis rates for infants aged 0–30 days (≤1-month age group; n = 16; 320.3 patient-months) and 31–365 days (>1–12-month age group; n = 10; 163.3 patient-months) at dialysis initiation were 0.27 (1 episode per 45.8 patient-months) and 0.15 (one episode per 81.7 patient-months), respectively. Seventy-six percent of the serum IgG levels were >1 standard deviation below the age-appropriate mean levels, and these did not differ in those who developed peritonitis versus those who did not (p = 0.39). Serum IgG levels were significantly lower in patients on CPD with oligoanuria than in non-oliguric patients (p = 0.04) and in patients on CPD for >90 days as compared to those who had received CPD for <90 days (p = 0.018). IVIG therapy was provided to 20 patients with hypogammaglobulinemia; this high prevalence of IVIG usage precluded any drawing of conclusion on the potential role of IVIG in the prevention of peritonitis. Conclusions: Hypogammaglobulinemia is a frequent complication of CPD during infancy. In our experience, it was not associated with an increased risk for peritonitis.
AB - Background: Peritonitis is a severe complication of chronic peritoneal dialysis (CPD) in infants. Few studies have been conducted to evaluate the relationship between hypogammaglobulinemia and peritonitis risk, and the potential benefit of intravenous immunoglobulins (IVIG) therapy in infants receiving CPD. Methods: Patients aged 0–12 months at initiation of CPD between 1985 and 2012 were eligible for inclusion in this retrospective study. Data collected from the start of CPD up to 2 years post-dialysis initiation included patient demographics, dialysis characteristics, serum immunoglobulin (IgG) levels, IVIG administration history, infectious complications and outcomes. Cox regression analysis and linear mixed model analysis were used for statistical analysis. Results: Twenty-six consecutive patients were included in the study. Annualized peritonitis rates for infants aged 0–30 days (≤1-month age group; n = 16; 320.3 patient-months) and 31–365 days (>1–12-month age group; n = 10; 163.3 patient-months) at dialysis initiation were 0.27 (1 episode per 45.8 patient-months) and 0.15 (one episode per 81.7 patient-months), respectively. Seventy-six percent of the serum IgG levels were >1 standard deviation below the age-appropriate mean levels, and these did not differ in those who developed peritonitis versus those who did not (p = 0.39). Serum IgG levels were significantly lower in patients on CPD with oligoanuria than in non-oliguric patients (p = 0.04) and in patients on CPD for >90 days as compared to those who had received CPD for <90 days (p = 0.018). IVIG therapy was provided to 20 patients with hypogammaglobulinemia; this high prevalence of IVIG usage precluded any drawing of conclusion on the potential role of IVIG in the prevention of peritonitis. Conclusions: Hypogammaglobulinemia is a frequent complication of CPD during infancy. In our experience, it was not associated with an increased risk for peritonitis.
KW - Hypogammaglobulinemia
KW - Immunoglobulin
KW - Infant dialysis
KW - Neonates
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=84990996801&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84990996801&partnerID=8YFLogxK
U2 - 10.1007/s00467-016-3487-1
DO - 10.1007/s00467-016-3487-1
M3 - Article
C2 - 27718085
AN - SCOPUS:84990996801
VL - 32
SP - 503
EP - 509
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 3
ER -