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Haemodiafiltration use in children: data from the Italian Pediatric Dialysis Registry

Fabio Paglialonga1, Enrico Vidal2, Carmine Pecoraro3

  • 1Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy. fabio.paglialonga@policlinico.mi.it.

Pediatric Nephrology (Berlin, Germany)
|January 7, 2019
PubMed

Insights

High volume haemodiafiltration (HDF) is used in about a quarter of children on dialysis in Italy. This advanced treatment is more common in younger patients with longer dialysis history and those awaiting kidney transplants.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Renal Replacement Therapy

Background:

  • High volume haemodiafiltration (HDF) shows improved survival in adult dialysis patients.
  • Limited data exists on HDF use and outcomes in pediatric populations.
  • This study investigates HDF prevalence in Italian children undergoing dialysis.

Purpose of the Study:

  • To determine the prevalence of paediatric HDF use in Italy.
  • To identify factors associated with HDF adoption in children.
  • To analyze trends in HDF utilization over time.

Main Methods:

  • Retrospective analysis of the Italian Pediatric Dialysis Registry database (2004-2016).
  • Inclusion criteria: patients on extracorporeal dialysis for at least 6 months.
  • Data collected on dialysis modality (HDF vs. bicarbonate HD) and patient characteristics.

Main Results:

  • HDF was used in 28.8% of 198 pediatric patients.
  • HDF patients were younger (median 9.7 vs. 13.2 years) and had longer dialysis vintage.
  • HDF use increased with dialysis duration and was more prevalent in larger centers.

Conclusions:

  • HDF use in Italian pediatric dialysis is limited to approximately 25% of patients.
  • HDF is favored in younger children, those with longer dialysis history, and those with extended waiting times for renal transplantation.
Abstract

Keywords:
ChildrenExtracorporeal dialysisHaemodiafiltrationHaemodialysisPaediatric dialysis

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