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Hemodialysis in children weighing less than 15 kg: a single-center experience

Yael Kovalski1, Roxana Cleper, Irit Krause

  • 1Nephrology and Dialysis Unit, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, Israel.

Pediatric Nephrology (Berlin, Germany)
|October 18, 2007
PubMed

Insights

Hemodialysis for infants with end-stage renal disease (ESRD) presents challenges but is viable. Successful transplantation was achieved in most pediatric patients, highlighting the importance of specialized centers for this critical treatment.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy

Background:

  • End-stage renal disease (ESRD) in infants poses significant treatment challenges.
  • Hemodialysis in low-weight pediatric patients (<15 kg) is associated with high morbidity and mortality.
  • Vascular access remains a primary obstacle in infant hemodialysis.

Purpose of the Study:

  • To evaluate the characteristics, morbidity, and outcomes of hemodialysis in infants with ESRD.
  • To identify complications and success rates of hemodialysis in pediatric patients awaiting transplantation.
  • To assess the feasibility of hemodialysis for ESRD management in infants.

Main Methods:

  • Retrospective review of 11 infants (<15 kg) with ESRD treated between 1995-2005.
  • Analysis of vascular access types, complications, and patient outcomes.
  • Evaluation of treatment characteristics and morbidity associated with hemodialysis.

Main Results:

  • Vascular access issues were frequent, with an average of three accesses per patient.
  • Mechanical difficulties and infections were leading causes for central-line removal.
  • Eight out of eleven patients successfully received kidney transplants; two patients died.

Conclusions:

  • Hemodialysis is a feasible option for low-weight pediatric patients with ESRD.
  • Care must be taken to manage complications such as hemodynamic instability and infections.
  • Successful transplantation is a key outcome, underscoring the need for expert management in specialized centers.

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