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An update on peritoneal dialysis and hemodialysis in the pediatric population

B A Warady1, T E Bunchman

  • 1Children's Mercy Hospital, Kansas City, MO 64108, USA.

Current Opinion in Pediatrics
|April 1, 1996
PubMed

Insights

Automated peritoneal dialysis is common for children needing renal replacement therapy. However, optimal dialysis targets and access remain undetermined, with focus on complications like infection and growth issues.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Dialysis

Background:

  • Automated peritoneal dialysis is the primary renal replacement therapy for most children.
  • Hemodialysis serves a significant pediatric patient subset.
  • Peritoneal membrane solute transport in children mirrors adult characteristics when standardized.

Purpose of the Study:

  • To highlight the need for defined adequacy targets in pediatric dialysis.
  • To address the lack of data on ideal dialysis access in children.
  • To shift focus towards understanding and preventing clinical complications.

Main Methods:

  • Review of existing literature on pediatric dialysis.
  • Analysis of peritoneal membrane solute transport studies.
  • Identification of research gaps in pediatric dialysis adequacy and access.

Main Results:

  • Pediatric and adult peritoneal membrane transport show similarities.
  • Established criteria for adequate dialysis (urea and creatinine clearance) are lacking for pediatric patients.
  • Clinical complications, not optimal parameters, dominate current research.

Conclusions:

  • Further research is crucial to establish dialysis adequacy targets for pediatric patients.
  • More data is needed to determine the best dialysis access methods for children.
  • Addressing complications requires a better understanding of optimal dialysis parameters and access.

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