J Korean Soc Pediatr Nephrol.  2007 Apr;11(1):41-50.

Chronic Dialysis in Infants and Children Under 2 Years of Age

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, School of Medicine Sungkyunkwan University, Seoul, Korea. drwhite@smc.samsung.co.kr

Abstract

PURPOSE: Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases.
METHODS
A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007.
RESULTS
At initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis.
CONCLUSION
Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function.

Keyword

Chronic dialysis; Peritoneal dialysis; Hemodialysis; Infant

MeSH Terms

Antihypertensive Agents
Body Weight
Catheters
Child*
Creatinine
Dialysis*
Erythropoietin
Follow-Up Studies
Humans
Infant*
Kidney Diseases
Kidney Failure, Chronic
Kidney Transplantation
Lost to Follow-Up
Medical Records
Peritoneal Dialysis
Quality of Life
Renal Dialysis
Retrospective Studies
Sepsis
Survival Rate
Antihypertensive Agents
Creatinine
Erythropoietin
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