ESPN 51th Annual Meeting

ESPN 2018


 
Acute hemodialysis experience in children weighing less than 15 kg
NESRIN TAŞ 1 BORA GÜLHAN 1 KÜBRA ÇELEGEN 1 GÜLŞAH ÖZDEMIR 1 ALI DÜZOVA 1 FATIH ÖZALTIN 1 REZAN TOPALOGLU 1

1- HACETTEPE UNIVERSITY FACULTY OF MEDICINE, DIVISION OF PEDIATRIC NEPHROLOGY
 
Introduction:

 Providing renal replacement therapy is challenging in small infants. Continuous veno-venous hemofiltration/dialysis (CVVH/D) and peritoneal dialysis (PD) are accepted dialysis modalities.  However CVVH/D is not always available because of cost constraints and incapabilities in technical infrastructure. Similarly, PD can not be performed for patients with recent abdominal surgery. We aimed to investigate clinical characteristics of a group of patients weighing less than 15 kg who had history of acute HD.

Material and methods:

 Clinical characteristics and follow-up of the patients with history of acute HD during hospitalization for various reasons were investigated. 

Results:

 A total of 28 patients (16 female, 12 male) were included. Mean age, body weight and body length at the time of HD was 2.5±1.6 years and 11.4±2.9 kg, 85.9±15.5 cm, respectively. Acute HD was performed in 23 patients for acute kidney injury and in 5 patients for removal of toxic metabolites. The most common (n=14, 50%) vascular access in the patients was femoral veins. Mean number of HD sessions was 3 (IQR; 2-6.8). Standart HD solution with bicarbonate is used in all patients. Priming was performed in 25 patients (89%). Mean blood flow during HD sessions was 119.1±19.4 ml/min. In HD sessions, hypotension and hypokalemia is observed in three and one patient, respectively. Blood flow was not different in patients who or who not developed hypotension during HD sessions (p=1.0). Dialysis related mortality was observed in one patient. Mean duration of follow-up was 1.8±1.5 years.  At last visit, median eGFR was 163.5 ml/min/1.73m2(IQR; 41.6-223.3) and chronic kidney disease is observed in 7 patients (25%).

Conclusions:

 Acute hemodialysis is an important RRT modality for patients that CVVH/D or PD can not be performed.