Hemodiafiltration (HDF) is increasingly adopted as a safe and effective treatment compared to conventional hemodialysis (HD) in children. We describe the outcomes of prospective observational studies in children on HDF versus HD showing that HDF was associated with an attenuation of the cardiovascular risk profile, improved blood pressure control, reduced inflammation, improved bone health and growth, and most importantly, an improved health-related quality of life.
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http://dx.doi.org/10.1111/sdi.13072 | DOI Listing |
Pediatr Nephrol
December 2024
Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.
Three-weekly 4-h hemodialysis/hemodiafiltration (HD/HDF) per week has become the "standard HD/HDF" regimen in children across the globe, although increasingly criticized, since crucial determinants such as residual kidney function and patient preferences are not considered. As a consequence, several children fail to achieve adequate dialysis while on a "standard HD/HDF." In these circumstances, an extended dialysis prescription such as short daily (2-3 h/session, 5-7 days a week) or nocturnal HD/HDF (6-9 h/session, 3-5 days a week), either at home or in a dialysis center, may be considered.
View Article and Find Full Text PDFLancet
October 2024
Great Ormond Street Institute of Child Health, University College London, London, UK.
Healthcare (Basel)
October 2024
Healthcare Management Program, School of Social Sciences, Hellenic Open University, 26335 Patras, Greece.
Background/objectives: The cost resulting from peritoneal dialysis (PD), conventional hemodialysis (HD) and online hemodiafiltration (OL-HDF) in pediatric patients with end-stage renal disease (ESRD) has not been estimated to date in Greece. The present single-center retrospective study aimed to estimate the mean annual cost of the above methods, as well as the individual components of this cost.
Methods: Twenty pediatric patients undergoing the three different methods of renal replacement therapy were included in this study.
Indian J Nephrol
May 2024
Division of Paediatric Nephrology, Okinawa Prefectural Nanbu Medical Centre, Children's Medical Centre, Haebaru, Japan.
Small intestinal bacterial overgrowth (SIBO) is a clinical syndrome involving gastrointestinal symptoms caused by the presence of excessive bacteria in the small intestine. SIBO often leads to diarrhea and poses diagnostic and treatment challenges. Here, we report about a renal transplant recipient who experienced diarrhea-induced hypovolemic shock due to SIBO, necessitating the reintroduction of dialysis, and aim to provide insights to aid health-care providers in diagnosing and managing severe diarrhea in this specific patient group.
View Article and Find Full Text PDFFront Pediatr
August 2024
Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Geneva, Switzerland.
We describe the case of a 14-year-old girl with osteosarcoma who was treated with high-dose methotrexate (12 g/m). Twenty-four hours after the infusion, her plasma methotrexate concentration was elevated at 937 μmol/L (normal < 10 µmol/L). She exhibited severe signs of methotrexate toxicity, including encephalopathy, acute liver failure (ALF), and acute kidney injury.
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