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Hemodialysis in the pediatric patient: state of the art

S L Goldstein1

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. stuartg@bcm.tmc.edu

Advances in Renal Replacement Therapy
|September 5, 2001
PubMed

Insights

Pediatric hemodialysis outcomes require better measurement tools. This study proposes improved methods for assessing hemodialysis adequacy and discusses technological advances for pediatric end-stage renal disease (ESRD) patient care.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Dialysis Technology

Background:

  • Increasing prevalence of pediatric patients requiring hemodialysis.
  • Lack of long-term outcome studies for children on hemodialysis.
  • Challenges in measuring hemodialysis adequacy and quality of life in pediatric patients.

Purpose of the Study:

  • To review issues surrounding hemodialysis adequacy measurement in children.
  • To propose simple and accurate methods for estimating Kt/V and normalized protein catabolic rate (nPCR).
  • To review technological advances for monitoring pediatric hemodialysis patients.

Main Methods:

  • Review of existing literature on pediatric hemodialysis adequacy.
  • Proposal of estimation methods for Kt/V and nPCR in children.
  • Discussion of continuous noninvasive hematocrit monitoring and ultrasound dilution vascular access flow measurement.

Main Results:

  • Proposed Kt/V and nPCR estimation methods facilitate widespread use for urea clearance and nutritional status assessment.
  • Reviewed technologies offer potential for improved patient monitoring.
  • Identified need for pediatric ESRD-specific quality of life assessment tools.

Conclusions:

  • Improved methods for measuring hemodialysis adequacy are crucial for pediatric outcome studies.
  • Technological advancements can enhance the care and monitoring of children undergoing hemodialysis.
  • Further research is needed for both short-term and long-term outcomes in pediatric hemodialysis.

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