Evaluating physiological measures and anemia management in pediatric patients with end stage renal disease: Peritoneal versus hemodialysis

The mortality rate of pediatric ESRD patients is greatly reduced following renal transplantation; however, renal transplantation seems to elude minority pediatric patients, with the average wait for organ transplantation being twice the median time amongst non-Hispanic white and twice the mortality rates. As a result, a significant number of minorities pediatric ESRD patients end up on hemodialysis (HD) compared to their white counterparts who are more likely to receive peritoneal dialysis (PD). This study applied Orem's self-care model. The purpose of this study was to compare and contrast physiological variables (blood pressure, creatinine levels and hemogloblin/ hematocrit levels) in pediatric patients on peritoneal versus hemodialysis to determine their effect on anemia management. A retrospective chart review was utilized in data collection. A total of 103 patients were included in this study. The data was analyzed using the SPSS 21.0 for Windows. Analysis was both descriptive and inferential. ANCOVA was used to assess the differences in the physiologic measures in PD versus HD patients. Odds ratios and Cox regression analysis were used to assess the relationship between physiological variables and anemia management in PD versus HD. As anticipated, physiological variables, including blood pressure, creatinine levels, and hemoglobin/hematocrit levels within recommended parameters in PD compared to HD patients, showed significant relationships. Also, anemia management was significant in BP, Hgb, and Cr levels. This study demonstrates the significant relationships in physiological measures and differences in HD vs PD outcomes. It also reinforces the need to evaluate these measures to facilitate effective anemia management.