Standardizing Blood Pressure Measurements in Pediatric Hemodialysis: a Collaborative Journey.

Purpose Of Review: This manuscript details the development and execution of a quality improvement (QI) initiative aimed at standardizing blood pressure (BP) measurement practices in pediatric hemodialysis (HD) units across a national dialysis collaborative.

Recent Findings: Although there are recommendations for the detection and treatment of hypertension in the pediatric population, currently there is no data or recommendations specific to the methodology of measuring blood pressure in a pediatric hemodialysis setting. In 2016, the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) Collaborative assembled a dedicated working group to thoroughly examine BP measurement practices across participating pediatric HD centers and, drawing from current research, to establish a standardized best practice for BP measurement in pediatric HD patients both in-center and at home.

Faster rate of blood volume change in pediatric hemodialysis patients impairs cardiac index.

Background: Intradialytic hypotension and myocardial stunning are proposed as contributing to the pathogenesis of increased cardiovascular disease burden and death in patients receiving maintenance hemodialysis (HD). Noninvasive cardiac output measurements provide a dynamic, real-time assessment of hemodynamic parameters. We investigated intradialytic changes in hemodynamic parameters in pediatric outpatients receiving chronic HD and determined patient and treatment risk factors associated with such intradialytic changes.

Increasing Vaccination Rates in a Pediatric Chronic Hemodialysis Unit.

Children with chronic kidney disease (CKD) are at an increased risk for serious complications from vaccine-preventable childhood diseases. Despite this risk, vaccination rates remain low. The barriers to vaccination in the pediatric population on dialysis are multifactorial.

Using a non-invasive method in chronic hemodialysis pediatric patients to estimate hemoglobin.

Background: Maintaining hemoglobin (Hgb) levels within a target range is difficult. Non-invasive hematocrit monitoring (NIVH) continuously monitors both the hematocrit and percent change in intravascular blood volume in real time. Based on the data reported here, NIVH can be utilized as a tool for anemia management in pediatric hemodialysis patients.