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Pediatric Nephrology

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01-02-2016 | Original Article

Long-term hemodialysis therapy in neonates and infants with end-stage renal disease: a 16-year experience and outcome

Authors: Shirley Pollack, Israel Eisenstein, Mahdi Tarabeih, Hadas Shasha-Lavski, Daniella Magen, Israel Zelikovic

Published in: Pediatric Nephrology | Issue 2/2016

Abstract

Background

Peritoneal dialysis is the preferred mode of renal replacement therapy in infants with end-stage renal disease (ESRD). Hemodialysis (HD) is seldom used in neonates and infants due to the risk of major complications in the very young.

Methods

Demographic, clinical, laboratory, and imaging data on all infants younger than 12 months with ESRD who received HD in our Pediatric Dialysis Unit between January 1997 and June 2013 were analyzed.

Results

Eighteen infants (n = 6 male) with ESRD (median age 3 months; median weight 4.06 kg) received HD through a central venous catheter (CVC) for a total of 543 months (median duration per infant 16 months). Seven of the infants (39 %) were neonates, and five (28 %) had serious comorbidities. There were five episodes of CVC infection, which is a rate of 0.3/1000 CVC days. Median catheter survival time was 320 days. Most infants had good oral intake, and only four (22 %) required a gastric tube; 14 (78 %) infants displayed normal growth. Fourteen (78 %) infants had hypertension, of whom four (22 %) had severe cardiac complications; eight (44 %) showed delayed psychomotor development. Eleven (61 %) of the infants, including six (86 %) of the neonates, survived. Five (28 %) infants underwent renal transplantation; 10-year graft survival was 80 %.

Conclusions

Based on these results, long-term HD in neonates and infants with ESRD is technically feasible, can be implemented without major complications, carries a very low rate of CVC infection and malfunction, and results in adequate nutrition, good growth, as well as good kidney graft and patient survivals. Future efforts should aim to prevent hypertension and its cardiac sequelae, improve neurodevelopmental outcome, and lower mortality rate in these infants.

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Title: Long-term hemodialysis therapy in neonates and infants with end-stage renal disease: a 16-year experience and outcome
Authors: Shirley Pollack
Israel Eisenstein
Mahdi Tarabeih
Hadas Shasha-Lavski
Daniella Magen
Israel Zelikovic
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 2/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-015-3214-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term hemodialysis therapy in neonates and infants with end-stage renal disease: a 16-year experience and outcome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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