Ultrasound Support of Peritoneal Dialysis in Children

Background. Treatment of patients with acute kidney injury and chronic kidney disease requires renal replacement therapy, peritoneal dialysis (PD) is one of the methods.

Objective. Study of ultrasound capabilities in visualization of PD complications in children.

Materials and Methods. Over the last 10 years in the Department of Gravitational Blood Surgery and Hemodialysis of St. Vladimir's Hospital in Moscow, about 605 patients with acute kidney injury and chronic kidney disease aged from 1 month to 17 years 11 months receiving PD treatment were observed, half of them had complaints associated with PD and requiring echographic differential diagnosis. Ultrasound was performed on Acuson/Sequoia 512, Voluson E-8, Voluson E-10, Acuson NX3.

Results. The variants of peritoneal catheter (PC) visualization in normal and obstructed conditions were studied: omentum fragments, fat suspensions of the colon and uterine appendages fragments (fimbriae) were visualized as irregularly shaped echogenic inclusions inside the catheter. Dialysis peritonitis in the debut of the disease at ultrasound looked like a finely dispersed suspension in the dialysate, later there was organization of dialysate with the formation of a grid of organized fluid. The possibilities of echographic diagnosis of intestinal obstruction due to PD are analyzed, rare cases of visualization of encapsulating peritoneal fibrosis in children are presented. The possibilities of ultrasound in the assessment of scrotal complications of PD in infants, variants of visualization of ventral hernias are shown. Such rare complications of PD in children as tunnel and hemorrhagic complications are presented.

Conclusion

1. Abdominal ultrasound with targeted PC's imaging should be performed on a patient on PD immediately if any abdominal pathology is
2. Changes in the consistency of dialysate on ultrasound in PD allow us to judge the dynamics of the disease and predict the prospects of resumption of
3. PC disruption and dislocation in children can be accurately assessed echographically
4. Intestinal obstruction in children on PD, may be due to PC position, but it is rarely possible to visualize this on In the vast majority of cases, nonspecific changes typical of low bowel obstruction are visualized.
5. If children have hernias provoked by PD, ultrasound can reliably assess the size of the hernia’s sac or dialysate accumulation, visualize the size of the hernia gate and differentiate hernial

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