Need for low sodium concentration and frequent cycles of 3.86% glucose solution in children treated with acute peritoneal dialysis.

In acute renal failure (ARF) in the setting of a pediatric intensive care unit, most authors report the use of frequent cycles of (often low-volume) high-glucose solutions. That approach results in appropriate H2O ultrafiltration, but not in appropriate sodium removal, as a consequence of the sieving coefficient of sodium. That in turn leads not only to inefficient treatment of intravascular fluid overload, but also frequently to hypernatremia.

A new fast-melting oral formulation of desmopressin: a pharmacodynamic study in children with primary nocturnal enuresis.

Objective: To determine the pharmacodynamic properties of a new oral lyophilisate formulation of desmopressin (in single doses of 30, 60, 120, 240, 360 or 480 microg) in children with known primary nocturnal enuresis (PNE) and thus identify those dosages that could provide a duration of action corresponding to a typical length of night-time sleep in children with PNE; additional objectives were to determine the safety and tolerability of desmopressin in this population.

Patients And Methods: Children with PNE (mean three or more wet nights/week), aged 6-12 years, were randomized into a double-blind, placebo-controlled study. An overhydration technique was used before dosing to suppress endogenous vasopressin production and thereby ensure that any antidiuresis could be attributed to treatment.

Use of bicarbonate/lactate-buffered dialysate with a nighttime cycler, associated with a daytime dwell with icodextrin, may result in alkalosis in children.

The aim of peritoneal dialysis (PD) remains to deliver "appropriate" renal replacement therapy, including sufficient ultrafiltration, correction of acid-base balance, and adequate dialysis dose. We switched our pediatric patients on automated PD from standard lactate-buffered glucose solution (Dianeal: Baxter Healthcare SA, Castlebar, Ireland) to bicarbonate/lactate-buffered solution (Physioneal: Baxter Healthcare SA) as soon as it became available in our country. We also decided to deliver "optimal" dialysis in children by prescribing a long daytime dwell with icodextrin solution (Extraneal: Baxter Healthcare SA).