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Hemodialysis in children with end-stage renal disease

Dominik Müller1, Stuart L Goldstein

  • 1Department of Pediatric Nephrology, Charité University Hospital, Augustenburger Platz 1, 13353 Berlin, Germany.

Nature Reviews. Nephrology
|September 7, 2011
PubMed

Insights

Pediatric end-stage renal disease (ESRD) patients often require dialysis before transplantation. Advances improve outcomes for children on maintenance hemodialysis, enabling survival into adulthood with careful medical, nutritional, and psychosocial management.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Dialysis Management

Background:

  • End-stage renal disease (ESRD) in children necessitates renal replacement therapy, with dialysis frequently preceding kidney transplantation.
  • Significant advancements in pediatric hemodialysis over the past decade have improved patient survival rates, with many reaching adulthood.

Purpose of the Study:

  • To review the key components of optimal maintenance hemodialysis for pediatric patients.
  • To highlight critical medical, surgical, nutritional, and psychosocial considerations for children undergoing hemodialysis.

Main Methods:

  • This review synthesizes current knowledge on pediatric hemodialysis.
  • Key aspects discussed include vascular access, nutritional support, dialysis adequacy targets, pharmacotherapy, and quality of life assessment.

Main Results:

  • Improved outcomes in pediatric maintenance hemodialysis are linked to comprehensive management strategies.
  • Multifactorial considerations are essential for optimizing hemodialysis in children.

Conclusions:

  • Optimal hemodialysis for children with ESRD requires a holistic approach, addressing medical, nutritional, and psychosocial needs.
  • Effective management strategies contribute to improved long-term survival and quality of life for pediatric patients on maintenance hemodialysis.

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