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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
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Optimizing cardiovascular outcomes in pediatric dialysis

Rukshana Shroff1, Franz Schaefer2

  • 1Paediatric Nephrology Unit, University College London Great Ormond Street Hospital and Institute of Child Health, London, UK.

Kidney International
|November 14, 2025
PubMed

Insights

Children on dialysis face high cardiovascular risks. Early diagnosis and preventive strategies, potentially including intensified dialysis, are crucial for improving cardiovascular health and survival in pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Health in Children
  • Dialysis Therapy

Background:

  • Dialysis is essential but carries significant cardiovascular risks for children.
  • Cardiovascular events cause nearly 30% of deaths in pediatric dialysis patients.
  • Risk factors for cardiovascular disease are present before dialysis and worsen during treatment.

Purpose of the Study:

  • To review key cardiovascular disease risk factors in children undergoing dialysis.
  • To discuss strategies for optimizing cardiovascular outcomes in this population.
  • To highlight the importance of early diagnosis and prevention.

Main Methods:

  • Review of existing literature on cardiovascular disease in pediatric dialysis patients.
  • Analysis of traditional and uremia-related cardiovascular risk factors.
  • Discussion of current and intensified dialysis modalities and their potential cardioprotective effects.

Main Results:

  • Both peritoneal dialysis and conventional hemodialysis offer suboptimal toxin and fluid clearance.
  • Intensified dialysis regimens (hemodiafiltration, longer/frequent sessions) may offer benefits, but pediatric data are limited.
  • Modifiable cardiovascular risk factors require early diagnosis and management.

Conclusions:

  • Children on dialysis have a lifelong need for kidney replacement therapy, necessitating lifelong cardiovascular monitoring.
  • Focus must be on early diagnosis and robust preventive strategies to improve long-term cardiovascular health.
  • While intensified dialysis may slow progression, reversing established cardiovascular damage is not yet possible.

Keywords:
cardiovascular diseasechildrenhemodiafiltration (HDF)home hemodialysisperitoneal dialysis (PD)vascular calcification

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