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Frequent hemodialysis in children
Bradley A Warady1, Michel Fischbach, Denis Geary
1The Children's Mercy Hospital, Kansas City, MO 64108, USA. bwarady@cmh.edu
Advances in Chronic Kidney Disease
|July 3, 2007
Summary
Frequent hemodialysis, including intensive hemodiafiltration and nocturnal hemodialysis, shows promise for children with end-stage renal disease. These methods offer dietary freedom, better control, and improved growth, with more research needed.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
Background:
- Frequent hemodialysis is underutilized in pediatric end-stage renal disease (ESRD) care.
- Limited data exists on intensive hemodiafiltration and nocturnal hemodialysis in children.
Purpose of the Study:
- To review current understanding of frequent hemodialysis techniques in pediatric ESRD.
- To highlight the clinical and technical applications and outcomes of these therapies.
Main Methods:
- Review of preliminary experiences with intensive hemodiafiltration and nocturnal hemodialysis in pediatric patients.
- Inclusion of data on the NxStage System for frequent daily hemodialysis in pediatrics.
Main Results:
- Positive preliminary outcomes reported for intensive hemodiafiltration and nocturnal hemodialysis.
- Benefits include unrestricted diet/fluid intake, no need for phosphate binders, and excellent metabolic/BP control.
- Hemodiafiltration demonstrated excellent growth in pediatric patients.
Conclusions:
- Frequent hemodialysis approaches show significant potential for improving pediatric ESRD management.
- Further collaborative data collection and experience are essential to fully establish these therapies.
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