Devices for long-term hemodialysis in small children—a plea for action

Bruno Ranchin; Claus Peter Schmitt; Bradley Warady; Jonathan C. Craig; Christoph Licht; Hiroshi Hataya; Enrico Vidal; Johan Vande Walle; Rukshana Shroff

doi:10.1016/j.kint.2023.03.018

Devices for long-term hemodialysis in small children—a plea for action

Bruno Ranchin, Claus Peter Schmitt, Bradley Warady, Jonathan C. Craig, Christoph Licht, Hiroshi Hataya, Enrico Vidal, Johan Vande Walle, Rukshana Shroff

College of Medicine and Public Health

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

International registry data show that 11% to 37% of children initiating maintenance hemodialysis (HD) weigh less than 20 kg, with 4% to 14% weighing between 10 and 15 kg and 2% to 9% less than 10 kg. The smaller blood volume in young children necessitates both low-volume tubing systems and dialyzers, and dialysis machines with a high precision of ultrafiltration control. The safe and tolerable extracorporeal blood volume in an individual is less than 8 ml/kg body weight, corresponding to 10% of the total blood volume. If the extracorporeal volume exceeds this limit, circuit priming with human albumin or with packed red blood cells is recommended,4 which could expose children to foreign proteins and blood from multiple donors, with an inherent risk of allergic reactions, blood-borne infections, and human leucocyte antigen sensitization.

Original language	English
Pages (from-to)	1038-1040
Number of pages	3
Journal	Kidney International
Volume	103
Issue number	6
Early online date	28 Mar 2023
DOIs	https://doi.org/10.1016/j.kint.2023.03.018
Publication status	Published - Jun 2023

Keywords

children
device
equity
hemodialysis

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10.1016/j.kint.2023.03.018Licence: In Copyright

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title = "Devices for long-term hemodialysis in small children—a plea for action",

abstract = "International registry data show that 11% to 37% of children initiating maintenance hemodialysis (HD) weigh less than 20 kg, with 4% to 14% weighing between 10 and 15 kg and 2% to 9% less than 10 kg. The smaller blood volume in young children necessitates both low-volume tubing systems and dialyzers, and dialysis machines with a high precision of ultrafiltration control. The safe and tolerable extracorporeal blood volume in an individual is less than 8 ml/kg body weight, corresponding to 10% of the total blood volume. If the extracorporeal volume exceeds this limit, circuit priming with human albumin or with packed red blood cells is recommended,4 which could expose children to foreign proteins and blood from multiple donors, with an inherent risk of allergic reactions, blood-borne infections, and human leucocyte antigen sensitization.",

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AU - Ranchin, Bruno

AU - Schmitt, Claus Peter

AU - Warady, Bradley

AU - Craig, Jonathan C.

AU - Licht, Christoph

AU - Hataya, Hiroshi

AU - Vidal, Enrico

AU - Walle, Johan Vande

AU - Shroff, Rukshana

PY - 2023/6

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AB - International registry data show that 11% to 37% of children initiating maintenance hemodialysis (HD) weigh less than 20 kg, with 4% to 14% weighing between 10 and 15 kg and 2% to 9% less than 10 kg. The smaller blood volume in young children necessitates both low-volume tubing systems and dialyzers, and dialysis machines with a high precision of ultrafiltration control. The safe and tolerable extracorporeal blood volume in an individual is less than 8 ml/kg body weight, corresponding to 10% of the total blood volume. If the extracorporeal volume exceeds this limit, circuit priming with human albumin or with packed red blood cells is recommended,4 which could expose children to foreign proteins and blood from multiple donors, with an inherent risk of allergic reactions, blood-borne infections, and human leucocyte antigen sensitization.

KW - children

KW - device

KW - equity

KW - hemodialysis

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Devices for long-term hemodialysis in small children—a plea for action

Abstract

Keywords

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