Intensified hemodialysis regimens: neglected treatment options for children and adolescents |
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Authors: | Dominik Müller Miriam Zimmering Christopher T. Chan Philip A. McFarlane Andreas Pierratos Uwe Querfeld |
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Affiliation: | 1.Department of Pediatric Nephrology,Charité – Universit?tsmedizin Berlin,Berlin,Germany;2.Division of Nephrology, Toronto General Hospital,University Health Network,Toronto,Canada;3.Division of Nephrology, St. Michael’s Hospital,University of Toronto,Toronto,Canada;4.Humber River Regional Hospital, Department of Medicine,University of Toronto,Weston,Canada |
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Abstract: | During recent years, the importance of intensified dialysis regimens has gathered increasing interest, especially after the Hemodialysis (HEMO) Study Group reported that a higher dose of thrice-weekly hemodialysis failed to improve clinical outcomes. Long nocturnal hemodialysis (three to six times per week) or short daily hemodialysis are the currently used forms of intensified dialysis. There is substantial evidence for cardiovascular and quality-of-life improvements as well as financial benefits with intensified hemodialysis. Preliminary experience with daily hemodialysis and hemodiafiltration in children has been reported. Given the continuing shortage of donor organs for kidney transplantation, the increasing incidence of end-stage renal disease (ESRD) and recognition of the deleterious effects of long-lasting ESRD, growth retardation, and poor social rehabilitation, more intensified dialysis regimens are a much-needed therapeutical option in both adults and children. |
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Keywords: | End stage renal disease Intensified hemodialysis Nocturnal dialysis Children |
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