A Hospital-Based Intermittent Nocturnal Hemodialysis Program for Children and Adolescents

• Published in: The Journal of pediatrics Vol. 158; no. 1; pp. 64 - 68.e1
• Main Authors: Hoppe, Anne, von Puttkamer, Christina, Linke, Ursula, Kahler, Cindy, Booß, Martina, Braunauer-Kolberg, Renate, Hofmann, Katja, Joachimsky, Petra, Hirte, Ingrid, Schley, Sylke, Utsch, Boris, Thumfart, Julia, Briese, Sonia, Gellermann, Jutta, Zimmering, Miriam, Querfeld, Uwe, Müller, Dominik
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 2011; Elsevier
• Subjects: Adolescent; adolescents; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Child, Preschool; children; dialysis; drug therapy; Emergency and intensive care: renal failure. Dialysis management; Female; General aspects; hemodialysis; Hospitalization; Humans; Infant; Intensive care medicine; kidney transplant; Male; Medical sciences; methods; morbidity; mortality; parathyroid hormone; patients; Pediatrics; potassium phosphates; Prospective Studies; quality of life; Renal Dialysis; Renal Dialysis - methods; urea; NHD; Nocturnal hemodialysis; Human; Extrarenal dialysis; Pediatrics; Program; Night; Hemodialysis; Intermittent; Adolescent; Hospital environment; Hospital; Child
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2010.06.036

To establish a hospital-based nocturnal hemodialysis (NHD) program for children and adolescents. Sixteen patients (age, 0.5 to 17 years) were prospectively included. Uremia-associated measures as well as amount and dosage of medication were enumerated. Quality of life also was evaluated. Results were compared with data of the same patients on conventional hemodialysis and with matched control subjects (conventional HD). NHD was well tolerated. Median Kt/V values increased. Predialytic mean arterial pressure, urea, phosphate, and parathyroid hormone levels decreased. There was an increase in protein catabolic rate. Dietary and fluid restrictions could be lifted. Amount and dosage of phosphate and potassium binders and antihypertensive medication could be reduced. Quality of life improved and days of absence from school decreased in all patients. In addition to a better control of uremia-associated measures, NHD allows free dietary and fluid intake and improves patient well-being. Given the continuing shortage of donor organs for kidney transplantation and the high morbidity and mortality on conventional HD, intensified dialysis regimens are a much-needed therapeutic option.