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Chronic hemodialysis in children weighing less than 10 kg

Catherine Quinlan1, Marie Bates, Aishling Sheils

  • 1Department of Nephrology, The Children's University Hospital, Temple Street, Dublin 1, Ireland. cathyquinlan@mac.com

Pediatric Nephrology (Berlin, Germany)
|December 25, 2012
PubMed

Insights

Chronic hemodialysis (HD) is a viable option for infants under 10 kg when peritoneal dialysis fails. Careful vascular access management minimizes complications, ensuring successful long-term treatment for pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Infant Health

Background:

  • Hemodialysis (HD) is typically a second-line treatment for infants when peritoneal dialysis (PD) is unsuccessful.
  • This study examines the use of HD in infants weighing less than 10 kg.

Purpose of the Study:

  • To evaluate the morbidity, complications, and outcomes of long-term HD in infants weighing less than 10 kg.
  • To assess the viability of HD as a management option for this specific pediatric population.

Main Methods:

  • A retrospective review of clinical data for infants under 10 kg undergoing HD for over 6 months was performed.
  • Data collected included demographics, anthropometrics, diet, vascular access details, HD prescription, complications, and outcomes.

Main Results:

  • Nine infants meeting the criteria were analyzed, with a median age of 9 months at HD initiation.
  • Growth parameters showed improvement during HD, with median energy and protein intake of 96.6 kcal/kg/day and 1.66 g/kg/day, respectively.
  • Vascular access demonstrated good longevity (median 13 months for central venous catheters) and low infection rates (0.14/patient year), with a median of 0.32 line changes/patient year.

Conclusions:

  • Chronic HD is a feasible treatment for infants weighing less than 10 kg.
  • Effective vascular access care is crucial for maximizing catheter longevity and minimizing infection rates in this cohort.
Abstract

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