Infectious Complications of Peritoneal Dialysis in Children with End-Stage Renal Disease

End-stage renal disease (ESRD) affects children of all ages worldwide. During their lifetimes, these children undergo a continuous sequence of renal replacement therapies: hemodialysis (HD), peritoneal dialysis (PD), and transplantation, and consequently, face a significantly shortened life expectancy. Although transplant remains the treatment of choice, 75% of children with ESRD now require treatment with dialysis prior to receiving a kidney transplant, and ultimately, upon allograft failure, will need to return to dialysis. Dialysis is, for that reason, a life-saving therapy for children and adolescents with ESRD, and conditions that complicate or negatively impact dialysis need to be prevented or minimized in this population. With patients on PD, peritonitis is an important cause of morbidity, mortality, and functional failure of the peritoneal membrane and a complication that has been reported to occur more commonly in children than in adults.