Chronic haemodialysis in small children: a retrospective study of the Italian Pediatric Dialysis Registry

Fabio Paglialonga, Silvia Consolo, Carmine Pecoraro, Enrico Vidal, Bruno Gianoglio, Flora Puteo, Stefano Picca, Maria Teresa Saravo, Alberto Edefonti, Enrico Verrina

Research output: Contribution to journalArticle

Abstract

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

Original languageEnglish
Pages (from-to)833-841
Number of pages9
JournalPediatric Nephrology
Volume31
Issue number5
DOIs
Publication statusPublished - May 1 2016

Keywords

  • Central venous catheter
  • Extracorporeal dialysis
  • Haemodiafiltration
  • Paediatric dialysis modality
  • Young children

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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    Paglialonga, F., Consolo, S., Pecoraro, C., Vidal, E., Gianoglio, B., Puteo, F., Picca, S., Saravo, M. T., Edefonti, A., & Verrina, E. (2016). Chronic haemodialysis in small children: a retrospective study of the Italian Pediatric Dialysis Registry. Pediatric Nephrology, 31(5), 833-841. https://doi.org/10.1007/s00467-015-3272-6