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Optimal hemodialysis prescription: do children need more than a urea dialysis dose?

Fischbach Michel1, Zaloszyc Ariane, Schaefer Betti

  • 1Nephrology Dialysis Transplantation Children's Unit, University Hospital Hautepierre, Avenue Molière, 67098 Strasbourg, France.

International Journal of Nephrology
|June 11, 2011
PubMed

Insights

Frequent hemodialysis (HD) in children can optimize treatment by improving blood pressure and growth. This approach may offer benefits beyond just rescue therapy, but requires further research.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy

Background:

  • Hemodialysis prescription in children requires establishing an adequate regimen before optimization.
  • A complete dialysis dose includes urea dialysis dose and convective volume.

Purpose of the Study:

  • To evaluate the effectiveness of frequent on-line hemodiafiltration (HDF) in pediatric patients.
  • To assess the impact of frequent HDF on blood pressure control and growth in children.

Main Methods:

  • A single-center study was conducted to investigate frequent on-line HDF.
  • The study focused on outcomes related to blood pressure and nutritional status.

Main Results:

  • Frequent on-line HDF demonstrated optimal dialysis prescription benefits.
  • Improved blood pressure control, avoidance of left ventricular hypertrophy, and catch-up growth were observed.
  • Reduced malnutrition, cachexia, and growth hormone resistance were noted.

Conclusions:

  • Frequent on-line HDF may represent an optimal dialysis strategy for children.
  • This approach offers advantages in managing blood pressure and promoting growth.
  • Further prospective randomized studies are needed to validate these findings.

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