Skip to main content
SpringerLink
Log in

Interdialytic weight gain in oligoanuric children and adolescents on chronic hemodialysis

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Little is known about the clinical impact of interdialytic weight gain (IDWG) on oligoanuric children undergoing chronic hemodialysis (HD).

Methods

We retrospectively assessed IDWG, left ventricular mass index (LVMI) and its changes (ΔLVMI), pre-HD systolic and diastolic blood pressure (DBP), residual urine output, Kt/V, the frequency of intradialytic symptoms, normalized protein catabolic rate, and the 3-month change in the dry weight of 16 hemodialyzed oligoanuric patients with a median age of 14.8 years (range 5.0–17.9).

Results

There was a significant correlation between IDWG and median LVMI (r 0.55, p = 0.026), which was 27.3 g/m2.7 (22.5–37.6) in the patients with a median IDWG of <4 %, and 44.3 g/m2.7 (28.2–68.7) in those with a median IDWG of >4 % (p = 0.003). None of the four patients with an IDWG of <4 % showed left ventricular hypertrophy, compared with 10 of the 12 patients (83.3 %) with an IDWG of >4 % (p = 0.003); the former also had a better median ΔLVMI (−33.5 % vs −13.0 %; p = 0.02) and a lower median DBP sds (0.24 vs 1.72, p = 0.04).

Conclusions

There is a significant correlation between IDWG and LVMI in pediatric oligoanuric patients on chronic HD: those with an IDWG of >4 % are at a higher risk of left ventricular hypertrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629

    Article  PubMed  Google Scholar 

  2. Glassock RJ, Pecoits-Filho R, Barberato SH (2009) Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol 4(Suppl 1):S79–S91

    Article  PubMed  Google Scholar 

  3. Drukker A, Urbach J, Glaser J (1981) Hypertrophic cardiomyopathy in children with end-stage renal disease and hypertension. Proc Eur Dial Transplant Assoc 18:542–547

    CAS  PubMed  Google Scholar 

  4. Borzych D, Bakkaloglu SA, Zaritsky J, Suarez A, Wong W, Ranchin B, Qi C, Szabo AJ, Coccia PA, Harambat J, Mitu F, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Defining left ventricular hypertrophy in children on peritoneal dialysis. Clin J Am Soc Nephrol 6:1934–1943

    Article  PubMed Central  PubMed  Google Scholar 

  5. Bakkaloglu SA, Borzych D, Soo Ha I, Serdaroglu E, Büscher R, Salas P, Patel H, Drozdz D, Vondrak K, Watanabe A, Villagra J, Yavascan O, Valenzuela M, Gipson D, Ng KH, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Cardiac geometry in children receiving chronic peritoneal dialysis: findings from the international pediatric peritoneal dialysis network (IPPN) registry. Clin J Am Soc Nephrol 6:1926–1933

    Article  PubMed Central  PubMed  Google Scholar 

  6. Mitsnefes MM, Daniels SR, Schwartz SM, Meyer RA, Khoury P, Strife CF (2000) Severe left ventricular hypertrophy in pediatric dialysis: prevalence and predictors. Pediatr Nephrol 14:898–902

    Article  CAS  PubMed  Google Scholar 

  7. Mitsnefes MM, Daniels SR, Schwartz SM, Khoury P, Strife CF (2001) Changes in left ventricular mass in children and adolescents during chronic dialysis. Pediatr Nephrol 16:318–323

    Article  CAS  PubMed  Google Scholar 

  8. Chavers BM, Solid CA, Sinaiko A, Daniels FX, Chen SC, Collins AJ, Frankenfield DL, Herzog CA (2011) Diagnosis of cardiac disease in pediatric end-stage renal disease. Nephrol Dial Transplant 26:1640–1645

    Article  PubMed Central  PubMed  Google Scholar 

  9. Sozeri B, Mir S, Kara OD, Levent E (2010) When does the cardiovascular disease appear in patients with chronic kidney disease? Pediatr Cardiol 31:821–828

    Article  PubMed  Google Scholar 

  10. Bakkaloglu SA, Saygily A, Sever L, Noyan A, Akman S, Ekim M, Aksu N, Doganay B, Yildiz N, Duzova A, Soylu A, Alpay H, Sonmez F, Civilibal M, Erdem S, Kardelen F (2009) Assessment of cardiovascular risk in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report. Nephrol Dial Transplant 24:3525–3532

    Article  PubMed  Google Scholar 

  11. Civilibal M, Caliskan S, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Bugra Z, Arisoy N (2007) Traditional and “new” cardiovascular risk markers and factors in pediatric dialysis patients. Pediatr Nephrol 22:1021–1029

    Article  PubMed  Google Scholar 

  12. Koc Y, Unsal A, Kayabasi H, Oztekin E, Sakaci T, Ahbap E, Yilmaz M, Akgun AO (2011) Impact of volume status on blood pressure and left ventricle structure in patients undergoing chronic hemodialysis. Ren Fail 33:377–381

    Article  CAS  PubMed  Google Scholar 

  13. Agarwal R, Bouldin JM, Light RP, Garg A (2011) Probing dry-weight improves left ventricular mass index. Am J Nephrol 33:373–380

    Article  PubMed Central  PubMed  Google Scholar 

  14. Goldfarb-Rumyantzev AS, Chelamcharla M, Bray BE, Leypoldt JK, Lavasani I, Nelson N, Lavasani T, Baird B, Cheung AK (2009) Volume indicators and left ventricular mass during aggressive volume management in patients on thrice-weekly hemodialysis. Nephron Clin Pract 113:c270–c280

    Article  PubMed  Google Scholar 

  15. Dheu C, Terzic J, Menouer S, Fischbach M (2009) Importance of the curve shape for interpretation of blood volume monitor changes during haemodiafiltration. Pediatr Nephrol 24:1419–1423

    Article  PubMed  Google Scholar 

  16. Candan C, Sever L, Civilibal M, Caliskan S, Arisoy N (2009) Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients. Pediatr Nephrol 24:581–587

    Article  PubMed  Google Scholar 

  17. Dietel T, Filler G, Grenda R, Wolfish N (2000) Bioimpedance and inferior vena cava diameter for assessment of dialysis dry weight. Pediatr Nephrol 14:903–907

    Article  CAS  PubMed  Google Scholar 

  18. Patel HP, Goldstein SL, Mahan JD, Smith B, Fried CB, Currier H, Flynn JT (2007) A standard, noninvasive monitoring of hematocrit algorithm improves blood pressure control in pediatric hemodialysis patients. Clin J Am Soc Nephrol 2:252–257

    Article  PubMed  Google Scholar 

  19. Brooks ER, Fatallah-Shaykh SA, Langman CB, Wolf KM, Price HE (2008) Bioelectric impedance predicts total body water, blood pressure, and heart rate during hemodialysis in children and adolescents. J Ren Nutr 18:304–311

    Article  PubMed  Google Scholar 

  20. Fenech M, Maasrani M, Jaffrin MY (2001) Fluid volumes determination by impedance spectroscopy and hematocrit monitoring: application to pediatric hemodialysis. Artif Organs 25:89–98

    Article  CAS  PubMed  Google Scholar 

  21. Paglialonga F, Ardissino G, Galli MA, Scarfia RV, Testa S, Edefonti A (2012) Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis. Hemodial Int 16:S20–S25

    Article  PubMed  Google Scholar 

  22. Hothi DK, Rees L, Marek J, Burton J, McIntyre CW (2009) Pediatric myocardial stunning underscores the cardiac toxicity of conventional hemodialysis treatments. Clin J Am Soc Nephrol 4:790–797

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Movilli E, Gaggia P, Zubani R, Camerini C, Vizzardi V, Parrinello G, Savoldi S, Fischer MS, Londrino F, Cancarini G (2007) Association between high ultrafiltration rates and mortality in uraemic patients on regular haemodialysis. A 5-year prospective observational multicentre study. Nephrol Dial Transplant 22:3547–3552

    Article  PubMed  Google Scholar 

  24. Rajan VR, Mitch WE (2008) Muscle wasting in chronic kidney disease: the role of the ubiquitin proteasome system and its clinical impact. Pediatr Nephrol 23:527–535

    Article  PubMed Central  PubMed  Google Scholar 

  25. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458

    Article  CAS  PubMed  Google Scholar 

  26. Daniels SR, Kimball TR, Morrison JA, Khoury P, Meyers RA (1995) Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease. Am J Cardiol 76:699–701

    Article  CAS  PubMed  Google Scholar 

  27. Katsoufis C, Seeherunvong W, Sasaki N, Abitbol CL, Chandar J, Freundlich M, Zilleruelo GE (2014) Forty-four-hour interdialytic ambulatory blood pressure monitoring and cardiovascular risk in pediatric hemodialysis patients. Clin Kidney J 7:33–39

    Article  PubMed Central  PubMed  Google Scholar 

  28. Zaloszyc A, Schaefer B, Schaefer F, Krid S, Salomon R, Niaudet P, Schmitt CP, Fischbach M (2013) Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis. Pediatr Nephrol 28:2169–2177

    Article  PubMed  Google Scholar 

  29. Fischbach M, Dheu C, Seuge L, Menouer S, Terzic J (2008) In-center daily on-line hemodiafiltration: a 4-year experience in children. Clin Nephrol 69:279–284

    Article  CAS  PubMed  Google Scholar 

  30. Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A (2010) Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrol Dial Transplant 25:867–873

    Article  CAS  PubMed  Google Scholar 

  31. Fischbach M, Terzic J, Laugel V, Dheu C, Menouer S, Helms P, Livolsi A (2004) Daily on-line haemodiafiltration: a pilot trial in children. Nephrol Dial Transplant 19:2360–2367

    Article  PubMed  Google Scholar 

  32. Goldstein SL, Silverstein DM, Leung JC, Feig DI, Soletsky B, Knight C, Warady BA (2008) Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis. Pediatr Nephrol 23:129–135

    Article  PubMed  Google Scholar 

  33. Warady BA, Fischbach M, Geary D, Goldstein SL (2007) Frequent hemodialysis in children. Adv Chron Kidney Dis 14:297–303

    Article  Google Scholar 

  34. Fischbach M, Fothergill H, Zaloszyc A, Menouer S, Terzic J (2011) Intensified daily dialysis: the best chronic dialysis option for children? Semin Dial 24:640–644

    Article  PubMed  Google Scholar 

  35. Müller D, Zimmering M, Chan CT, McFarlane PA, Pierratos A, Querfeld U (2008) Intensified hemodialysis regimens: neglected treatment options for children and adolescents. Pediatr Nephrol 23:1729–1736

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Nephrology and Dialysis Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy

    Fabio Paglialonga, Silvia Consolo, Sara Testa & Alberto Edefonti

  2. Pediatric Cardiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Maria Albina Galli

Authors
  1. Fabio Paglialonga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvia Consolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Albina Galli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Testa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alberto Edefonti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fabio Paglialonga.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Paglialonga, F., Consolo, S., Galli, M.A. et al. Interdialytic weight gain in oligoanuric children and adolescents on chronic hemodialysis. Pediatr Nephrol 30, 999–1005 (2015). https://doi.org/10.1007/s00467-014-3005-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-014-3005-2

Keywords

Search

Navigation