PMID- 26054713 OWN - NLM STAT- MEDLINE DCOM- 20160810 LR - 20181113 IS - 1432-198X (Electronic) IS - 0931-041X (Linking) VI - 30 IP - 11 DP - 2015 Nov TI - Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis-A survey from the European Paediatric Dialysis Working Group. PG - 2021-7 LID - 10.1007/s00467-015-3137-z [doi] AB - BACKGROUND: Pleural or pericardial effusions secondary to pleuro-peritoneal fistula (PPF) and pericardio-peritoneal fistula (PcPF) are rare but serious complications of peritoneal dialysis (PD). METHODS: 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. RESULTS: 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. CONCLUSION: 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. FAU - Dufek, Stephanie AU - Dufek S AD - Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK. Stephanie.dufek@gosh.nhs.uk. FAU - Holtta, Tuula AU - Holtta T AD - Renal Unit, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. tuula.hollta@hus.fi. FAU - Fischbach, Michel AU - Fischbach M AD - Renal Unit, Hospital de Hautepierre, Strasbourg, France. michel.fischbach@chru-strasbourg.fr. FAU - Ariceta, Gema AU - Ariceta G AD - Renal Unit, Hospital Cruces, Barakaldo, Vizcaya, Spain. gariceta@vhebron.net. FAU - Jankauskiene, Augustina AU - Jankauskiene A AD - Renal Unit, Vilnius University, Vilnius, Lithuania. augustina.jankauskiene@mf.vu.lt. FAU - Cerkauskiene, Rimante AU - Cerkauskiene R AD - Renal Unit, Vilnius University, Vilnius, Lithuania. rimante.cerkauskiene@mf.vu.lt. FAU - Schmitt, Claus Peter AU - Schmitt CP AD - Renal Unit, Center for Pediatric & Adolescent Medicine, Heidelberg, Germany. claus.peter.schmitt@med.uni-heidelberg.de. FAU - Schaefer, Betti AU - Schaefer B AD - Renal Unit, Center for Pediatric & Adolescent Medicine, Heidelberg, Germany. betti.schaefer@med.uni-heidelberg.de. FAU - Aufricht, Christoph AU - Aufricht C AD - Renal Unit, University Hospital of Vienna, Vienna, Austria. christoph.aufricht@meduniwien.ac.at. FAU - Wright, Elizabeth AU - Wright E AD - Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK. liz.wright@gosh.nhs.uk. FAU - Stefanidis, Constantinos J AU - Stefanidis CJ AD - Renal Unit, "A & P Kyriakou" Children's Hospital, Athens, Greece. cjstefanidis@gmail.com. FAU - Ekim, Mesiha AU - Ekim M AD - Renal Unit, Ankara University Hospital, Ankara, Turkey. ekim@medicine.ankara.edu.tr. FAU - Bakkaloglu, Sevcan AU - Bakkaloglu S AD - Renal Unit, Gazi University Hospital, Ankara, Turkey. sevcan@gazi.edu.tr. FAU - Klaus, Gunter AU - Klaus G AD - Renal Unit, KfH Pediatric Kidney Center, Marburg, Germany. klaus@mailer.uni-marburg.de. FAU - Zurowska, Aleksandra AU - Zurowska A AD - Renal Unit, Gdansk University Medical School, Gdansk, Poland. azur@amg.gda.pl. FAU - Vondrak, Karel AU - Vondrak K AD - Renal Unit, University Hospital Motol, Prague, Czech Republic. karel.vondrak@lfmotol.cuni.cz. FAU - Vande Walle, Johan AU - Vande Walle J AD - Renal Unit, UZ Gent, Gent, Belgium. johan.vandewalle@uzgent.be. FAU - Edefonti, Alberto AU - Edefonti A AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. aedefonti@hotmail.com. FAU - Shroff, Rukshana AU - Shroff R AD - Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK. Rukshana.Shroff@gosh.nhs.uk. CN - European Paediatric Dialysis Working Group LA - eng PT - Journal Article DEP - 20150609 PL - Germany TA - Pediatr Nephrol JT - Pediatric nephrology (Berlin, Germany) JID - 8708728 SB - IM MH - Ascitic Fluid/*pathology MH - Child MH - Child, Preschool MH - Europe MH - Female MH - Fistula/epidemiology/*etiology MH - Humans MH - Incidence MH - Infant MH - Kidney Failure, Chronic/therapy MH - Male MH - Pericardial Effusion/epidemiology/*etiology MH - Peritoneal Dialysis/*adverse effects MH - Pleural Effusion/epidemiology/*etiology MH - Prevalence MH - Surveys and Questionnaires OTO - NOTNLM OT - Children OT - Pericardial effusion OT - Pericardio-peritoneal fistula OT - Peritoneal dialysis OT - Pleural effusion OT - Pleuro-peritoneal fistula EDAT- 2015/06/10 06:00 MHDA- 2016/08/11 06:00 CRDT- 2015/06/10 06:00 PHST- 2015/04/22 00:00 [received] PHST- 2015/05/26 00:00 [accepted] PHST- 2015/05/19 00:00 [revised] PHST- 2015/06/10 06:00 [entrez] PHST- 2015/06/10 06:00 [pubmed] PHST- 2016/08/11 06:00 [medline] AID - 10.1007/s00467-015-3137-z [pii] AID - 10.1007/s00467-015-3137-z [doi] PST - ppublish SO - Pediatr Nephrol. 2015 Nov;30(11):2021-7. doi: 10.1007/s00467-015-3137-z. Epub 2015 Jun 9.