TY - JOUR
T1 - Chronic haemodialysis in small children
T2 - a retrospective study of the Italian Pediatric Dialysis Registry
AU - Paglialonga, Fabio
AU - Consolo, Silvia
AU - Pecoraro, Carmine
AU - Vidal, Enrico
AU - Gianoglio, Bruno
AU - Puteo, Flora
AU - Picca, Stefano
AU - Saravo, Maria Teresa
AU - Edefonti, Alberto
AU - Verrina, Enrico
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background: Chronic haemodialysis (HD) in small children has not been adequately investigated. Methods: This was a retrospective investigation of the use of chronic HD in 21 children aged 10 years were analysed. Results: The median age of the 21 children at start of HD was 11.4 [interquartile range (IQR) 6.2–14.6] months, and HD consisted mainly of haemodiafiltration for 3–4 h in ≥4 sessions/week. A total of 51 central venous catheters were placed, and the median survival of tunnelled and temporary lines was 349 and 31 days, respectively (p <0.001). Eight children (38 %) showed evidence of central vein thrombosis. Although 19 % of patients received growth hormone and 63.6 % received enteral feeding, the weight and height of these patients remained suboptimal. During the HD period the haemoglobin level increased in all patients, but not to normal levels (from 8.5 to 9.6 g/dl) despite erythropoietin administration (503–600 U/kg/week). The hospitalisation rate was 1.94/patient-year. Seventeen patients underwent renal transplantation at a median age of 3.0 years. Four patients, all affected by severe comorbidities, died during follow-up (in 2 cases due to absence of a vascular access). The 5- and 10-year cumulative survival was 82.4 and 68.7 %, respectively. Conclusions: Extracorporeal dialysis is feasible in children aged
AB - Background: Chronic haemodialysis (HD) in small children has not been adequately investigated. Methods: This was a retrospective investigation of the use of chronic HD in 21 children aged 10 years were analysed. Results: The median age of the 21 children at start of HD was 11.4 [interquartile range (IQR) 6.2–14.6] months, and HD consisted mainly of haemodiafiltration for 3–4 h in ≥4 sessions/week. A total of 51 central venous catheters were placed, and the median survival of tunnelled and temporary lines was 349 and 31 days, respectively (p <0.001). Eight children (38 %) showed evidence of central vein thrombosis. Although 19 % of patients received growth hormone and 63.6 % received enteral feeding, the weight and height of these patients remained suboptimal. During the HD period the haemoglobin level increased in all patients, but not to normal levels (from 8.5 to 9.6 g/dl) despite erythropoietin administration (503–600 U/kg/week). The hospitalisation rate was 1.94/patient-year. Seventeen patients underwent renal transplantation at a median age of 3.0 years. Four patients, all affected by severe comorbidities, died during follow-up (in 2 cases due to absence of a vascular access). The 5- and 10-year cumulative survival was 82.4 and 68.7 %, respectively. Conclusions: Extracorporeal dialysis is feasible in children aged
KW - Central venous catheter
KW - Extracorporeal dialysis
KW - Haemodiafiltration
KW - Paediatric dialysis modality
KW - Young children
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U2 - 10.1007/s00467-015-3272-6
DO - 10.1007/s00467-015-3272-6
M3 - Article
SN - 0931-041X
VL - 31
SP - 833
EP - 841
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 5
ER -