title: Why does three times per week hemodialysis provide inadequate dialysis for children?
abstract: The duration of chronic conventional dialysis is a risk factor in children, both in terms of growth retardation and cardiovascular morbidity and mortality. Therefore, we need to develop alternative strategies, such as preemptive kidney transplantation and/or more intensive dialysis prescription. Indeed, conventional hemodialysis could be improved in all children by the use of high permeable membrane and ultrapure dialysis fluids (having very low endotoxin levels); by the addition of a convective dialysis dose to the urea diffusion dialysis dose (Kt/Vurea), i.e., hemodiafiltration; moreover, by the preservation of cardiovascular morphology and function (optimized blood pressure control); and also by the prescription of more frequent/longer dialysis sessions.
authors.affiliation: Nephrology Dialysis Transplantation Children's Unit, University Hospital Hautepierre, Strasbourg, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Fischbach
authors.forename: Ariane
authors.initials: A
authors.lastname: Zaloszyc
authors.forename: Higel
authors.initials: H
authors.lastname: Laetitia
authors.forename: Soraya
authors.initials: S
authors.lastname: Menouer
authors.forename: Joelle
authors.initials: J
authors.lastname: Terzic
mesh_terms: D002648:Child; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods* / Q000592:standards*; D012307:Risk Factors
keywords: Hemodialysis duration; daily; growth; hemodialysis frequency; intensive dialysis