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Acute complications of haemodialysis in paediatric age group
1Department of Paediatric Nephrology, The Children's Hospital & Institute of Child Health, Lahore.drfarkh@hotmail.com
Insights
Acute complications of haemodialysis in children with end-stage renal disease (ESRD) include hypertension and headache. While life-saving, haemodialysis requires careful monitoring for potential adverse events like catheter infections and electrolyte disturbances.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- End-stage renal disease (ESRD) necessitates renal replacement therapy.
- Haemodialysis is a common treatment modality for pediatric ESRD patients.
- Understanding acute complications is crucial for patient safety.
Purpose of the Study:
- To evaluate the incidence and types of acute complications during haemodialysis in children with ESRD.
- To identify the most frequent adverse events associated with this procedure in a pediatric population.
Main Methods:
- An observational study was conducted over two years.
- 25 children (age 6-14 years) with ESRD underwent haemodialysis.
- Complications were systematically recorded during 519 sessions.
Main Results:
- Hypertension (40.46%), headache (13.87%), and muscle cramps (8.6%) were common clinical issues.
- Catheter infections (12.50%) and hypokalemia (8%) were significant concerns.
- Technical issues like dialyzer clotting (0.95%) and UV control module failure (3.42%) were also noted.
Conclusions:
- Haemodialysis is a vital treatment but carries inherent risks for pediatric ESRD patients.
- Hypertension, headache, muscle cramps, and catheter infections are the most prevalent complications.
- Close monitoring and management are essential to mitigate these risks.
Objective:
To assess acute complications of haemodialysis in patients with end-stage renal disease (ESRD).
Design:
Observational study.
Place And Duration Of Study:
The Nephrology Department of The Children's Hospital and Institute of Child Health, Lahore over a period of 2 years (January 2001-December 2002).
Patients And Methods:
The children in age group of 6-14 years, suffering from end-stage renal disease (ESRD), were provided renal replacement therapy in the form of haemodialysis mostly twice a week and were observed for the complications of the procedure.
Results:
A total 519 haemodialysis were performed on 25 patients. The mean age was 11.06 years and weight was 26.8 kg. The clinical problems observed were hypertension in 40.46%, hypotension 3.4%, chest pain 4.04%, headache 13.87%, vomiting 1.73%, gastrointestinal bleeding 1.92%, muscle cramps 8.6% and convulsions 0.57% of sessions. Hypokalemia was main electrolyte disturbance seen during 8%, while fever with rigors and chills in 4.02% of sessions. Minor bleeding from subclavian catheter was seen during 2.89% of sessions while thrombosis, infection and accidental dislodgment in 0.77%, 12.50% and 0.57% of sessions respectively. Technical problems like clotting in dialyzer during 0.95% and failure of ultra-violet control module was seen in 3.42% of sessions.
Conclusion:
Haemodialysis, a life saving treatment modality, is not without risk of complications. Hypertension, headache, muscle cramps and catheter infections were the most commonly encountered complications in this series.
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