Acute complications of haemodialysis in paediatric age group.

Objective: To assess acute complications of haemodialysis in patients with end-stage renal disease (ESRD).

Design: Observational study.

Place And Duration Of Study: The Nephrology Department of The Children's Hospital and Institute of Child Health, Lahore over a period of 2 years (January 2001-December 2002).

Patients And Methods: The children in age group of 6-14 years, suffering from end-stage renal disease (ESRD), were provided renal replacement therapy in the form of haemodialysis mostly twice a week and were observed for the complications of the procedure.

Results: A total 519 haemodialysis were performed on 25 patients. The mean age was 11.06 years and weight was 26.8 kg. The clinical problems observed were hypertension in 40.46%, hypotension 3.4%, chest pain 4.04%, headache 13.87%, vomiting 1.73%, gastrointestinal bleeding 1.92%, muscle cramps 8.6% and convulsions 0.57% of sessions. Hypokalemia was main electrolyte disturbance seen during 8%, while fever with rigors and chills in 4.02% of sessions. Minor bleeding from subclavian catheter was seen during 2.89% of sessions while thrombosis, infection and accidental dislodgment in 0.77%, 12.50% and 0.57% of sessions respectively. Technical problems like clotting in dialyzer during 0.95% and failure of ultra-violet control module was seen in 3.42% of sessions.

Conclusion: Haemodialysis, a life saving treatment modality, is not without risk of complications. Hypertension, headache, muscle cramps and catheter infections were the most commonly encountered complications in this series.