Skip to main content
Erschienen in: Pediatric Nephrology 5/2013

01.05.2013 | Original Article

Chronic hemodialysis in children weighing less than 10 kg

verfasst von: Catherine Quinlan, Marie Bates, Aishling Sheils, Niamh Dolan, Michael Riordan, Atif Awan

Erschienen in: Pediatric Nephrology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Hemodialysis (HD) in infants is usually used when peritoneal dialysis (PD) has failed. We describe our experience with HD, outlining the morbidity, complications, and outcomes for infants weighing less than 10 kg managed with HD for more than 6 months over a 10-year period.

Methods

A retrospective review of the clinical notes was conducted to collect demographic information, anthropometric data, dietary history, site and form of vascular access, details of HD prescription, complications, and outcomes.

Results

Nine patients weighing less than 10 kg were hemodialyzed for more than 6 months. Median age at commencement was 9 months. Median weight and height standard deviation score (SDS) at commencement of HD were −2.14 and −0.61, respectively, and at the end they were −1.56 and −1.61. Median energy intake was 96.6 kcal/kg/day and protein intake was 1.66 g/kg/day. Median number of line revisions was 0.32 line changes/patient year. Median central venous catheter (CVC) longevity was 13 months. Mean rate of line infection was 0.14/patient year. Median time on HD was 27 months. Median age at transplantation was 3.4 years.

Conclusions

This case series shows that chronic HD is a viable management option in children <10 kg. Access issues can be minimized with good line care to maximize line longevity and minimize line infection rates.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Lewis MA, Shaw J, Sinha MD, Adalat S, Hussain F, Castledine C, van Schalkwyk D, Inward C (2010) UK Renal Registry 12th Annual Report (December 2009): chapter 14: demography of the UK paediatric renal replacement therapy population in 2008. Nephron Clin Pract 115(Suppl 1):c279–88PubMedCrossRef Lewis MA, Shaw J, Sinha MD, Adalat S, Hussain F, Castledine C, van Schalkwyk D, Inward C (2010) UK Renal Registry 12th Annual Report (December 2009): chapter 14: demography of the UK paediatric renal replacement therapy population in 2008. Nephron Clin Pract 115(Suppl 1):c279–88PubMedCrossRef
2.
Zurück zum Zitat Mateer FM, Greenman L, Danowski TS (1955) Hemodialysis of the uremic child. AMA Am J Dis Child 89:645–655PubMed Mateer FM, Greenman L, Danowski TS (1955) Hemodialysis of the uremic child. AMA Am J Dis Child 89:645–655PubMed
3.
Zurück zum Zitat Al-Hermi BE, Al-Saran K, Secker D, Geary DF (1999) Hemodialysis for end-stage renal disease in children weighing less than 10 kg. Pediatr Nephrol 13:401–403PubMedCrossRef Al-Hermi BE, Al-Saran K, Secker D, Geary DF (1999) Hemodialysis for end-stage renal disease in children weighing less than 10 kg. Pediatr Nephrol 13:401–403PubMedCrossRef
4.
Zurück zum Zitat Shroff R, Wright E, Ledermann S, Hutchinson C, Rees L (2003) Chronic hemodialysis in infants and children under 2 years of age. Pediatr Nephrol 18:378–383PubMed Shroff R, Wright E, Ledermann S, Hutchinson C, Rees L (2003) Chronic hemodialysis in infants and children under 2 years of age. Pediatr Nephrol 18:378–383PubMed
5.
Zurück zum Zitat Kovalski Y, Cleper R, Krause I, Davidovits M (2007) Hemodialysis in children weighing less than 15 kg: a single-center experience. Pediatr Nephrol 22:2105–2110PubMedCrossRef Kovalski Y, Cleper R, Krause I, Davidovits M (2007) Hemodialysis in children weighing less than 15 kg: a single-center experience. Pediatr Nephrol 22:2105–2110PubMedCrossRef
6.
Zurück zum Zitat Cole TJ, Freeman JV, Preece MA (1998) British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med 17:407–429PubMedCrossRef Cole TJ, Freeman JV, Preece MA (1998) British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med 17:407–429PubMedCrossRef
7.
Zurück zum Zitat Shaw V, Lawson M (2008) Clinical Paediatric Dietetics. Wiley-Blackwell, New York Shaw V, Lawson M (2008) Clinical Paediatric Dietetics. Wiley-Blackwell, New York
8.
Zurück zum Zitat KDOQI, National Kidney Foundation (2006) KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 47:S11–145CrossRef KDOQI, National Kidney Foundation (2006) KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 47:S11–145CrossRef
9.
Zurück zum Zitat Carey WA, Talley LI, Sehring SA, Jaskula JM, Mathias RS (2007) Outcomes of dialysis initiated during the neonatal period for treatment of end-stage renal disease: a North American pediatric renal trials and collaborative studies special analysis. Pediatrics 119:e468–73PubMedCrossRef Carey WA, Talley LI, Sehring SA, Jaskula JM, Mathias RS (2007) Outcomes of dialysis initiated during the neonatal period for treatment of end-stage renal disease: a North American pediatric renal trials and collaborative studies special analysis. Pediatrics 119:e468–73PubMedCrossRef
10.
Zurück zum Zitat Goldstein SL (1997) Hemodialysis catheter survival and complications in children and adolescents. Pediatr Nephrol 11:74–77 Goldstein SL (1997) Hemodialysis catheter survival and complications in children and adolescents. Pediatr Nephrol 11:74–77
11.
Zurück zum Zitat Subcommittee RAS, London RCOPO, Society BT, Nephrologists BAOP. Treatment of adults and children with renal failure. Royal College of Physicians; 2002. www.renal.org Subcommittee RAS, London RCOPO, Society BT, Nephrologists BAOP. Treatment of adults and children with renal failure. Royal College of Physicians; 2002. www.​renal.​org
12.
Zurück zum Zitat Hannah EL, Stevenson KB, Lowder CA, Adcox MJ, Davidson RL, Mallea MC, Narasimhan N, Wagnild JP (2002) Outbreak of hemodialysis vascular access site infections related to malfunctioning permanent tunneled catheters: making the case for active infection surveillance. Infect Control Hosp Epidemiol 23:538–541PubMedCrossRef Hannah EL, Stevenson KB, Lowder CA, Adcox MJ, Davidson RL, Mallea MC, Narasimhan N, Wagnild JP (2002) Outbreak of hemodialysis vascular access site infections related to malfunctioning permanent tunneled catheters: making the case for active infection surveillance. Infect Control Hosp Epidemiol 23:538–541PubMedCrossRef
13.
Zurück zum Zitat Saxena AK, Panhotra BR, Al-Mulhim AS (2005) Vascular access-related infections in hemodialysis patients. Saudi J Kidney Dis Transpl 16:46–71PubMed Saxena AK, Panhotra BR, Al-Mulhim AS (2005) Vascular access-related infections in hemodialysis patients. Saudi J Kidney Dis Transpl 16:46–71PubMed
14.
Zurück zum Zitat Beathard GA (2003) Catheter management protocol for catheter-related bacteremia prophylaxis. Semin Dial 16:403–405PubMedCrossRef Beathard GA (2003) Catheter management protocol for catheter-related bacteremia prophylaxis. Semin Dial 16:403–405PubMedCrossRef
15.
Zurück zum Zitat Stefanidis CJ (2009) Prevention of catheter-related bacteremia in children on hemodialysis: time for action. Pediatr Nephrol 24:2087–2095PubMedCrossRef Stefanidis CJ (2009) Prevention of catheter-related bacteremia in children on hemodialysis: time for action. Pediatr Nephrol 24:2087–2095PubMedCrossRef
16.
Zurück zum Zitat Karlberg J, Schaefer F, Hennicke M, Wingen AM, Rigden S, Mehls O (1996) Early age-dependent growth impairment in chronic renal failure. European study group for nutritional treatment of chronic renal failure in childhood. Pediatr Nephrol 10:283–287PubMed Karlberg J, Schaefer F, Hennicke M, Wingen AM, Rigden S, Mehls O (1996) Early age-dependent growth impairment in chronic renal failure. European study group for nutritional treatment of chronic renal failure in childhood. Pediatr Nephrol 10:283–287PubMed
17.
Zurück zum Zitat Ulinski T, Cochat P (2006) Longitudinal growth in children following kidney transplantation: from conservative to pharmacological strategies. Pediatr Nephrol 21:903–909PubMedCrossRef Ulinski T, Cochat P (2006) Longitudinal growth in children following kidney transplantation: from conservative to pharmacological strategies. Pediatr Nephrol 21:903–909PubMedCrossRef
18.
Zurück zum Zitat Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A (2010) Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrol Dial Transplant 25:867–873PubMedCrossRef Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A (2010) Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrol Dial Transplant 25:867–873PubMedCrossRef
19.
Zurück zum Zitat Fischbach M, Terzic J, Menouer S, Dheu C, Soskin S, Helmstetter A, Burger M-C (2006) Intensified and daily hemodialysis in children might improve statural growth. Pediatr Nephrol 21:1746–1752PubMedCrossRef Fischbach M, Terzic J, Menouer S, Dheu C, Soskin S, Helmstetter A, Burger M-C (2006) Intensified and daily hemodialysis in children might improve statural growth. Pediatr Nephrol 21:1746–1752PubMedCrossRef
20.
Zurück zum Zitat Fine RN, Martz K, Stablein D (2010) What have 20 years of data from the North American Pediatric Renal Transplant Cooperative Study taught us about growth following renal transplantation in infants, children, and adolescents with end-stage renal disease? Pediatr Nephrol 25:739–746PubMedCrossRef Fine RN, Martz K, Stablein D (2010) What have 20 years of data from the North American Pediatric Renal Transplant Cooperative Study taught us about growth following renal transplantation in infants, children, and adolescents with end-stage renal disease? Pediatr Nephrol 25:739–746PubMedCrossRef
21.
Zurück zum Zitat Kari JA, Gonzalez C, Ledermann SE, Shaw V, Rees L (2000) Outcome and growth of infants with severe chronic renal failure. Kidney Int 57:1681–1687PubMedCrossRef Kari JA, Gonzalez C, Ledermann SE, Shaw V, Rees L (2000) Outcome and growth of infants with severe chronic renal failure. Kidney Int 57:1681–1687PubMedCrossRef
22.
Zurück zum Zitat KDOQI Work Group (2009) KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 update. Executive summary. Am J Kidney Dis 53:S11–104 KDOQI Work Group (2009) KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 update. Executive summary. Am J Kidney Dis 53:S11–104
23.
Metadaten
Titel
Chronic hemodialysis in children weighing less than 10 kg
verfasst von
Catherine Quinlan
Marie Bates
Aishling Sheils
Niamh Dolan
Michael Riordan
Atif Awan
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Pediatric Nephrology / Ausgabe 5/2013
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-012-2373-8

Weitere Artikel der Ausgabe 5/2013

Pediatric Nephrology 5/2013 Zur Ausgabe

Educational Review

Home haemodialysis

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

23.04.2024 Typ-1-Diabetes Nachrichten

Wenn Kinder an Werktagen zum Arzt gehen, werden neu auftretender Typ-1-Diabetes und diabetische Ketoazidosen häufiger erkannt als bei Arztbesuchen an Wochenenden oder Feiertagen.

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

22.04.2024 Fehlsichtigkeit Nachrichten

Augentropfen mit niedrig dosiertem Atropin können helfen, das Fortschreiten einer Kurzsichtigkeit bei Kindern zumindest zu verlangsamen, wie die Ergebnisse einer aktuellen Studie mit verschiedenen Dosierungen zeigen.

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 Spinale Muskelatrophien Nachrichten

Seit 2021 ist die Untersuchung auf spinale Muskelatrophie Teil des Neugeborenen-Screenings in Deutschland. Eine Studie liefert weitere Evidenz für den Nutzen der Maßnahme.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.