Assessment and management of fluid overload in children on dialysis

Wesley Hayes, Fabio Paglialonga

Research output: Contribution to journalArticle


Dysregulation of intravascular fluid leads to chronic volume overload in children with end-stage kidney disease (ESKD). Sequelae include left ventricular hypertrophy and remodeling and impaired cardiac function. As a result, cardiovascular complications are the commonest cause of mortality in the pediatric dialysis population. The clinical need to optimize intravascular volume in children with ESKD is clear; however, its assessment and management is the most challenging aspect of the pediatric dialysis prescription. Minimizing chronic fluid overload is a key priority; however, excessive ultrafiltration is toxic to the myocardium and can precipitate intradialytic symptoms. This review outlines emerging objective techniques to enhance the assessment of fluid overload in children on dialysis and outlines evidence for current management strategies to address this clinical problem.

Original languageEnglish
Pages (from-to)233-242
Number of pages10
JournalPediatric Nephrology
Issue number2
Publication statusPublished - 2019


  • Children
  • Dialysis
  • Fluid balance
  • Hypertension
  • Ultrasonography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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