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Grand Rounds in Pediatric Nephrology — an ISN-IPNA Sister Centers initiative: Make the peritoneal membrane work for you
The ISN, in partnership with the International Pediatric Nephrology Association (IPNA) and Dr. Rukshana Shroff, Great Ormond Street Hospital, London, UK, has developed a case-based online teaching program, “Grand Rounds in Pediatric Nephrology,” to support the training needs of active Sister Renal Centers (SRC) pairs and other centers in LMICs in light of restrictions imposed by the COVID-19 pandemic.
The second webinar will focus on optimizing PD. We will present the case of a 7-year-old girl with primary steroid resistant nephrotic syndrome secondary to focal segmental glomerulosclerosis, a compound heterozygous variant of NPHS2 on genetic studies. She progressed rapidly to end-stage kidney disease (ESKD) and when she first presented, had no residual renal function, was edematous and hypertensive.
Peritoneal dialysis (PD; manual) was started with an initial prescription of 1.5% dextrose, dwell volume 400 ml (660 ml/m2/day) x four cycles of 6 hours each. She had inadequate ultrafiltration, remained edematous and hypertensive, and required sequential modifications to the PD prescription. Transporter status and adequacy were assessed.
Learning objectives:
- Optimizing ultrafiltration
- Assessment of and optimizing solute clearance on PD
- Assessment of the membrane by the PET
Further reading:
- Warady BA, Schaefer F , Bagga A , Cano F, McCulloch M , Yap Hui-Kim, Shroff R. Prescribing peritoneal dialysis for high-quality care in children. Peritoneal Dialysis International 2020, 40(3) 333–340
- Brown EA, Blake PG, Boudville N, et al. International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis. Peritoneal Dialysis International. 2020;40(3):244-253.