Treatment of chronic uremia in childhood. II. Hemodialysis

• Published in: Pediatrics (Evanston) 1970-11, Vol.46 (5), p.678-689
• Main Authors: Potter, D, Larsen, D, Leumann, E, Perin, D, Simmons, J, Piel, C F, Holliday, M A
• Format: Article
• Language: English
• Subjects: Adolescent; Anemia - etiology; Arteriovenous Shunt, Surgical; Blood Flow Velocity; Blood Urea Nitrogen; Body Weight; Bone Diseases - etiology; Brachial Artery; Calcium - metabolism; Child; Child, Preschool; Creatinine - blood; Female; Femoral Artery; Growth; Heart Failure - etiology; Humans; Hypertension, Renal - etiology; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Kidney Transplantation; Kidneys, Artificial; Male; Pericarditis - etiology; Phosphorus - metabolism; Renal Dialysis - adverse effects; Uremia - complications; Uremia - therapy; Water-Electrolyte Balance
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.46.5.678

Fourteen children, 2 to 16 years of age, were dialyzed three times weekly for periods of 1 to 27 months on the modified Kiil or Dow Hollow Fiber Kidney. There was one death—from recurrence of Wilms' tumor—and seven children received renal transplants. The superficial femoral, brachial, posterior tibial, or radial artery was cannulated and blood flow during dialysis was > 150 ml/minute without a pump. Mean pre-dialysis serum urea nitrogen levels of 70 to 86 mg/100 ml were maintained in children from 10 to 52 kg by varying the efficiency of the dialyzer and the number of dialysis hours with the size of the child. The children were active and symptoms of uremia were uncommon. Complications found included hemodynamic effects of the shunt, shunt clotting and infection, anemia, hypertension, heart failure, and renal osteodystrophy. Growth was related to calorie intake and was normal in four of eight children. Chronic dialysis was considered successful therapy for uremic children.