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Why does three times per week hemodialysis provide inadequate dialysis for children?
Author(s) -
Fischbach Michel,
Zaloszyc Ariane,
Laetitia Higel,
Menouer Soraya,
Terzic Joelle
Publication year - 2014
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 - 10.1111/hdi.12222
Subject(s) - medicine , dialysis , hemodialysis , medical prescription , intensive care medicine , creatinine , blood urea nitrogen , pharmacology
The duration of chronic conventional dialysis is a risk factor in children, both in terms of growth retardation and cardiovascular morbidity and mortality. Therefore, we need to develop alternative strategies, such as preemptive kidney transplantation and/or more intensive dialysis prescription. Indeed, conventional hemodialysis could be improved in all children by the use of high permeable membrane and ultrapure dialysis fluids (having very low endotoxin levels); by the addition of a convective dialysis dose to the urea diffusion dialysis dose ( K t/ V urea), i.e., hemodiafiltration; moreover, by the preservation of cardiovascular morphology and function (optimized blood pressure control); and also by the prescription of more frequent/longer dialysis sessions.