title: Outcomes of Hemodialysis in Children: A 35-Year Experience at Severance Hospital.
abstract: OBJECTIVE
  The aim of this study was to analyze the results of children treated with hemodialysis (HD) at Severance Hospital over 35 years in terms of incidence, etiologies, characteristics, complications, and clinical outcomes.
  
  
  METHODS
  We analyzed 46 children admitted to Severance Hospital who had undergone HD between January 1979 and December 2013.
  
  
  RESULTS
  The main etiologies of the 23 end-stage renal disease (ESRD) patients who had received HD were chronic glomerulonephritis (7 patients, 30.4%) and congenital anomalies of the kidney and urinary tract (7 patients, 30.4%), whereas the etiology of the 23 acute kidney injury (AKI) patients was hemolytic uremic syndrome (6 patients, 26.1%). Compared with ESRD patients, hemocatheter placement in the femoral vein was preferred over the subclavian or internal jugular vein in the AKI patients (p=0.012). The most common complication was catheter related complication (10 patients, 21.7%). The site of hemocatheter insertion was not related to the frequency of oozing. Placing the hemocatheter in the femoral vein resulted in significantly more events of catheter obstruction than insertion in the internal jugular vein or the subclavian vein (p=0.001). Disequilibrium syndrome occurred more frequently in older patients (p=0.004), as well as patients with a greater body weight (p=0.008) and a higher systolic and diastolic blood pressure before HD (systolic: p=0.021; diastolic: p=0.040).
  
  
  CONCLUSIONS
  Based on the 35 years of experience in our center, HD can be sufficiently and safely carried out even in children without significant complications.
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, Daewoo General Hospital, Ajou University School of Medicine, Geoje, Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. shinji@yuhs.ac.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome
keywords: Hemodialysis; acute kidney injury; children; end stage renal disease