Frequent hemodialysis in children

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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
PubMed

Insights

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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