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Hemodialysis in children: principles and practice
M Fischbach1, J Terzic, S Menouer
1Nephrology Dialysis Transplantation Children's Unit, Strasbourg, France. Michel.Fishbach@chru-strasbourg.fr
Seminars in Nephrology
|September 18, 2001
Summary
Recent advancements in hemodialysis technology and clinical management have significantly reduced patient morbidity. Innovations like ultrapure dialysate and online hemodiafiltration offer improved patient outcomes and should be more widely adopted.
Area of Science:
- Nephrology
- Biomedical Engineering
Background:
- Hemodialysis has seen significant technological and clinical advancements in the past decade.
- Patient morbidity during hemodialysis sessions has decreased, with fewer seizures and rare hypotensive episodes or headaches.
Purpose of the Study:
- To review the technological and clinical improvements in hemodialysis over the last decade.
- To highlight the benefits of newer hemodialysis technologies and modalities for patient care.
Main Methods:
- Review of recent technological developments in hemodialysis machines and materials.
- Discussion of advancements in clinical management, including urea kinetic modeling and dialysate quality.
Main Results:
- Significant reduction in hemodialysis-related morbidity, including pain, seizures, and hypotension.
- Development and implementation of advanced technologies such as ultrapure dialysate, online monitoring, and biocompatible membranes.
- Urea kinetic modeling provides an assessment of dialysis dose (Kt/V) and protein intake.
Conclusions:
- Modern hemodialysis offers improved safety and efficacy due to technological progress.
- Online hemodiafiltration presents numerous advantages and should not be restricted to high-risk patients.