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[Chronic hemodialysis in children].

M A Delucchi1, E Wolff, F Cano

  • 1Unidad de Nefrología, Hospital Luis Calvo Mackenna.

Revista Chilena De Pediatria
|July 1, 1990
PubMed
Summary

Chronic hemodialysis in children with end-stage renal disease offers supportive care, managing symptoms and improving quality of life. This treatment is primarily a bridge to kidney transplantation, with some patients experiencing successful transplants or continuing dialysis.

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Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Clinical Medicine

Background:

  • End-stage renal failure in children presents significant challenges.
  • Chronic hemodialysis is a critical intervention for pediatric patients awaiting renal transplantation.

Purpose of the Study:

  • To report clinical features and outcomes of pediatric patients undergoing chronic hemodialysis.
  • To evaluate the effectiveness and complications of hemodialysis in children with terminal renal failure.
  • To assess the role of hemodialysis as supportive therapy preceding renal transplantation.

Main Methods:

  • Retrospective analysis of eight pediatric patients (4-15 years) with end-stage renal failure.
  • Utilized chronic hemodialysis via arteriovenous fistulas.

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  • Employed the kinetic urea model to assess dialysis performance.
  • Weekly dialysis sessions ranged from 9 to 12 hours.

    • Main Results:

    • Significant reductions observed in weight (1-3 kg), blood urea nitrogen (40 mg/dL), and serum potassium (2.5 mEq/L).
    • Primary complications included disequilibrium syndrome, arteriovenous fistula infections, and congestive heart failure.
    • Three patients underwent renal transplantation; one died, and two remain on chronic hemodialysis.

    Conclusions:

    • Chronic hemodialysis provides essential supportive care for children with end-stage renal disease.
    • Hemodialysis facilitates improved clinical parameters and allows children to attend school.
    • Renal transplantation remains the definitive treatment, with hemodialysis serving as a crucial temporary measure.