A Down syndrome patient treated with peritoneal dialysis

• Published in: Dialysis & transplantation 2006-03, Vol.35 (3), p.167-175
• Main Authors: Horcicka, Vladko, Zadrazil, Josef, Zahálková, Jana, Krejcí, Karel, Strebl, Pavel, Al Jabry, Sadek
• Format: Article
• Language: English
• ISSN: 0090-2934; 1932-6920
• DOI: 10.1002/dat.20000

Background Down syndrome patients are not always suited for peritoneal dialysis, mainly due to their lack of compliance with the procedure. We report a case of a 42‐year‐old male Down syndrome patient successfully treated with peritoneal dialysis. Methods The patient suffered from end‐stage renal disease caused by chronic pyelonephritis due to a dysplastic urinary tract. Comorbid conditions included hypothyroidism, hypertension, hyperlipidemia, malnutrition with obesity, left ventricle dysfunction, multiple corneal erosions, and glaucoma. Because, in this case, the patient's mother would be required to sit full time at his bedside during a hemodialysis procedure, a peritoneal dialysis program was preferred. The treatment was complicated by peritoneal catheter dysfunction leading to the prolongation of the draining out time and the need to change the position of the body during drainage in the 29th month of treatment. Results Three months later, when the patient became overhydrated and a dry ultrafiltration procedure in the hemodialysis unit became necessary, the peritoneal catheter was replaced, which solved this problem. Conclusion Although the peritoneal dialysis procedure in mentally retarded patients is prone to failure mainly because of an increased risk of peritonitis and a burn‐out syndrome among their parents, this patient's mother has been successfully treating him by for more than 4 years without a single episode of peritonitis.