Our global survey suggests that CPD is practiced successfully, albeit with major regional variation related to differences in economic wealth, in children around the globe. The variations encompass issues such as the acceptance of very young patients and those with associated comorbidities to chronic dialysis programs, the utilization of automated PD and expensive drugs, and the diagnostic management of peritoneal infections, but did not result in differences in technique survival. However, economic conditions do appear to affect mortality on dialysis and standardized height, a marker of global morbidity in children with chronic disease.
Considering the general health challenges to children in the developing world, and even allowing for the fact that CPD may be offered to only a limited proportion of eligible patients, pediatric nephrologists in the lower-income economies appear to perform remarkably well in providing maintenance PD once a treatment decision is made. The observed outcomes mirror the remarkable progress in establishing specialized pediatric dialysis units in many threshold countries during the past 10 - 15 years and raise hope that PD programs will soon become available and be managed successfully in more developing economies as their GNIs gradually increase. The global distribution of uniform dialysis equipment has certainly been key to this progress. Moreover, the universal availability of clinical practice guidelines, educational materials, and professional networks over the Internet has been instrumental in harmonizing standards of management on a global scale. The rapid adoption of the IPPN web portal by the pediatric PD community has been paradigmatic of that process.
The following principal investigators are contributing to the IPPN registry:
Argentina: L. Alconcher, Hospital Interzonal General, Bahia Blanca; E. Sojo, Hospital de Pediatria Garrahan, Buenos Aires; P.A. Coccia, Hospital Italiano de Buenos Aires; A. Suarez, Hospital de Niños Sor Maria Ludovica, La Plata; P.G. Valles, Hospital Pediatrico Humberto Notti, Mendoza; R. Salim, Rennius SA Salta. Belgium: K. van Hoeck, University Hospital Antwerp, Edegem. Brazil: V. Koch, Hospital das Clinicas FMUSP, Sao Paulo. Canada: J. Feber, Children’s Hospital of Eastern Ontario, Ottawa; D.A. Geary, Hospital for Sick Children, Toronto; C. White, BC Children’s Hospital, Vancouver. Chile: M. Valenzuela, Hospital Guillermo Grant Benavente, Concepcion; J. Villagra, Hospital Base, Osorno; F. Cano, Hospital Luis Calvo Mackenna, Santiago; M.A. Contreras, Roberto del Rio Hospital, Santiago; A. Vogel, Pontivicia Universidad Catolica de Chile, Santiago; P. Zambrano, Hospital Dr. Gonzales Cortes, Santiago; P. Berrocal, Hospital Sotero del Rio, Santiago. PR China: K.C. Tse, Princess Margret Hospital, Hong Kong; H. Xu, Children’s Hospital of Fudan University, Shanghai. Czech Republic: K. Vondrak, University Hospital Motol, Prague. Finland: K. Rönnholm, Hospital for Children and Adolescents, Helsinki. France: J. Harambat, Hôpital des Enfants, Bordeaux; B. Ranchin, Hôpital Femme Mère Enfant, Lyon; G. Roussey, CHU Nantes; T. Ulinski, Armand Trousseau Hospital, Paris; M. Fischbach, Children’s Dialysis Center, Strasbourg. Germany: R. Büscher, Children’s Hospital Essen; M. Kemper, University Medical Center, Hamburg; L. Pape, Medical School, Hannover; F. Schaefer and D. Borzych, Center for Pediatrics and Adolescent Medicine, Heidelberg; J. Misselwitz, Kidney Center for Children and Adolescents; G. Klaus, University Hospital, Marburg; D. Haffner, University Children’s Hospital, Rostock. Greece: F. Papachristou, Aristoteles University, Thessaloniki. Hungary: A. Szabo, 1st Department of Pediatrics, Semmelweis University, Budapest. India: A. Bagga, All India Institute of Medical Sciences, New Delhi; M. Kanitkar, Armed Forces Medical College, Pune. Italy: E. Verrina, G. Gaslini Institute, Genova; A. Edefonti, Fondazione Ospedale Maggiore Policlinico, Milano; E. Vidal, Pediatric Nephrology, Dialysis and Transplant Unit, Padova; G. Leozappa, Dipartimento Nefrologia-Urologia, Rome. Israel: D. Landau, Soroka Medical Center, Beer-Sheva. Korea: I.S. Ha, Dialysis Center for Children and Adolescents, Seoul; K.H. Paik, Samsung Medical Center, Seoul. Lebanon: B. Aoun, Rafik Hariri University Hospital, Beirut. Macedonia: E. Sahpazova, Pediatric Clinic, Skopje. Mexico: L. Sànchez Barbosa, Pediatric Hospital Medical Center SXXI, Cuahutemoc. New Zealand: W. Wong, Starship Children’s Hospital, Auckland. Netherlands: J.W. Groothoff, Academic Medical Center, Amsterdam. Nicaragua: Y. Silva, Hospital Infantil de Nicaragua, Managua. Peru: R. Loza Munarriz, Cayetano Heredia Hospital, Lima. Poland: A.M. Zurowska and D. Borzych, Medical University, Gdańsk; D. Drozdz, University Children’s Hospital, Krakow; M. Lipka, Children’s Memorial Health Institute, Warsaw; H. Ziolkowska, Public Paediatric Teaching Hospital, Warsaw; M. Sczepanska, Dialysis Division for Children, Zabrze. Romania: O. Brumariu, St. Maria Children’s Hospital, Iasi. Saudi Arabia: J. Kari, King AbdulAziz University Hospital, Jeddah. Singapore: H.K. Yap, Shaw-NKF-NUH Children’s Kidney Center. Spain: G. Ariceta, Hospital de Cruces, Baracaldo; F. Santos, Hospital Universitario Central de Asturias, Oviedo. Turkey: N. Besbas, Hacettepe University, Ankara; S. Bakkaloglu, Gazi University, Ankara; I. Bilge, Department of Pediatric Nephrology, Çapa-Istanbul; E. Serdaroglu, Dr. Behcet Children Research and Educational Hospital, Izmir; A. Bal, Tepecik Children and Research Hospital, Izmir; S. Mir, Ege University Faculty of Medicine, Izmir-Bornova. United Kingdom: L. Rees, Great Ormond Street Hospital, London; A.R. Watson, Children and Young People’s Kidney Unit, Nottingham. Uruguay: J. Grünberg, SE.N.NI.AD, Montevideo. United Arab Emirates: E. Simkova, Dubai Hospital. United States: L. Greenbaum, Children’s Healthcare Pediatric Dialysis Unit, Atlanta; A. Neu, Johns Hopkins Hospital, Baltimore; D. Askenazi, Children’s Hospital of Alabama, Birmingham; M. Ferris, University of North Carolina, Chapel Hill; H. Patel, Children’s Hospital, Columbus; S. Al-Akash, Driscoll Children’s Hospital, Corpus Christi; S. Pottoore, Children’s Medical Center, Dallas; V. Dharnidharka, Division of Pediatric Nephrology, Gainesville; T. Bunchman, Helen DeVos Children’s Hospital, Grand Rapids; A. Chua, Texas Children’s Hospital, Houston; B.A. Warady, Children’s Mercy Hospital, Kansas City; N. McAfee, Seattle Children’s Hospital; J. Zaritsky, UCLA Medical Center, Los Angeles.