Yonsei Med J.  2015 Jul;56(4):1007-1014. 10.3349/ymj.2015.56.4.1007.

Outcomes of Hemodialysis in Children: A 35-Year Experience at Severance Hospital

• Shin HS
• Oh JY
• Park SJ
• Kim JH
• Lee JS
• Shin JI

• KMID: 2366342
• DOI: http://doi.org/10.3349/ymj.2015.56.4.1007

Abstract

PURPOSE
The aim of this study was to analyze the results of children treated with hemodialysis (HD) at Severance Hospital over 35 years in terms of incidence, etiologies, characteristics, complications, and clinical outcomes.
MATERIALS AND METHODS
We analyzed 46 children admitted to Severance Hospital who had undergone HD between January 1979 and December 2013.
RESULTS
The main etiologies of the 23 end-stage renal disease (ESRD) patients who had received HD were chronic glomerulonephritis (7 patients, 30.4%) and congenital anomalies of the kidney and urinary tract (7 patients, 30.4%), whereas the etiology of the 23 acute kidney injury (AKI) patients was hemolytic uremic syndrome (6 patients, 26.1%). Compared with ESRD patients, hemocatheter placement in the femoral vein was preferred over the subclavian or internal jugular vein in the AKI patients (p=0.012). The most common complication was catheter related complication (10 patients, 21.7%). The site of hemocatheter insertion was not related to the frequency of oozing. Placing the hemocatheter in the femoral vein resulted in significantly more events of catheter obstruction than insertion in the internal jugular vein or the subclavian vein (p=0.001). Disequilibrium syndrome occurred more frequently in older patients (p=0.004), as well as patients with a greater body weight (p=0.008) and a higher systolic and diastolic blood pressure before HD (systolic: p=0.021; diastolic: p=0.040).
CONCLUSION
Based on the 35 years of experience in our center, HD can be sufficiently and safely carried out even in children without significant complications.

Keyword

Hemodialysis; children; acute kidney injury; end stage renal disease

MeSH Terms

Acute Kidney Injury/epidemiology
Body Weight
Child
Child, Preschool
Chronic Disease
Female
Humans
Infant
Jugular Veins
Kidney Failure, Chronic/epidemiology/*therapy
Male
Renal Dialysis/*methods
Treatment Outcome

Figure

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  Fig. 1 Incidence of acute kidney injury and end-stage renal disease for patients who received HD during a 35-year period at Severance Hospital. AKI, acute kidney injury; ESRD, end-stage renal disease; HD, hemodialysis.

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