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In‐Center Short Daily Dialysis and Children
Author(s) -
McCallum Matsell Grimmer , Beisetzer Casier Sumpton ElHawary Mantulak TM, DG, J, B, S, J, A, A.
Publication year - 2003
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1046/j.1492-7535.2003.01281.x
Subject(s) - medicine , dialysis , home hemodialysis , hemodialysis , population , peritoneal dialysis , regimen , intensive care medicine , environmental health
When faced with the realization that peritoneal dialysis (PD) is no longer feasible, what are the options for a 12 year old girl with End Stage Renal Disease, who also has Insulin Dependent Diabetes Mellitus? Recognizing that daily dialysis is the superior choice, how would In‐Center Short Daily Hemodialysis (SDHD) impact this child? What are the risks for children? What are the benefits? Do we follow conventional guidelines? How would this impact her family as they were already facing burnout? There is significant evidence to support the improved outcomes for the adult dialysis patient on Short Daily/Nocturnal Dialysis. There is limited data available on outcomes for the pediatric hemodialysis population. After team and family meetings, SDHD, via permcath was initiated. To provide daily structure for the child, the diabetic regimen and minimize loss of school time, dialysis starts at 0730 hours. Kt/v, URR measurements and non‐invasive blood monitoring continues. During the last eight months, better nutrition, diabetic control, no peritonitis, less phosphate binders, dietary and fluid restrictions, have resulted in increased school attendance, better performance and decreased hospitalization. BP control remains an issue. The family has arranged to have drivers on certain weekdays. The stress and workload is much less. Family time has improved. In conclusion, the bloodwork isn't always ideal and the BP is higher than we wish to see. Many questions still remain. However, the glow on her face as she describes getting to sleep in the top bunk, her latest sleepover and the “A” on her Math test has certainly influenced our decision to consider SDHD as the treatment of choice for our children requiring hemodialysis.