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[Surgically relevant problems of chronic hemodialysis in childhood]
1Kinderchirurgische Abteilung, Humboldt-Universität zu Berlin.
Insights
Approximately 100 children require chronic hemodialysis, with vascular access being crucial. Renal transplantation offers the best hope for reducing mortality in these pediatric patients.
Area of Science:
- Pediatric Nephrology
- Surgical Procedures in Children
- Renal Replacement Therapy
Background:
- Chronic hemodialysis in children presents unique challenges.
- Vascular access is a primary concern for effective treatment.
- Surgical interventions are frequently required to manage complications.
Purpose of the Study:
- To review common surgical procedures in pediatric hemodialysis patients.
- To highlight the importance of vascular access.
- To discuss management of complications and long-term outcomes.
Main Methods:
- Review of surgical procedures for pediatric hemodialysis.
- Analysis of vascular access techniques, favoring Cimino-fistula.
- Discussion of complications such as bleeding, renal osteopathy, and gastrointestinal issues.
Main Results:
- Cimino-fistula is the preferred vascular access method.
- Scribner-Shunt is rarely indicated.
- Nephrectomy can be complicated by bleeding.
- Total parathyroidectomy with autotransplantation is used for renal osteopathy.
- Gastrointestinal complications are observed.
Conclusions:
- Optimizing vascular access is key in pediatric hemodialysis.
- Management of surgical complications is essential.
- Increased renal transplantation is vital for improving survival rates in children on hemodialysis.
Abstract:
It is reported about 100 children undergo chronic hemodialysis. The most frequent operation is to get a sufficient vascular access. The Cimino-fistula is the best access. There is no more any regularly indication creating a Scribner-Shunt. The nephrectomy as also a frequent operation is complicated by bleeding. To cure the renal osteopathy total parathyroidectomy with autotransplantation is used. Gastritis, pancreatitis and disturbance of bowel movement are seen. The enhancement of renal transplantation will help to diminish mortality of patients undergoing hemodialysis.