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Dialysis therapy in end-stage renal disease

  • Symposium: Pediatric Nephrology
  • Published:
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Abstract

The prognosis for children on dialysis has improved significantly in the past two decades. Much of this improvement can be attributed to the realization that adequate nutrition is a critical element of dialysis therapy and long-term morbidity and mortality in the dialysis population are closely linked to the nutritional state. Recommendations for nutritional intake have been formulated for infants and children with end-stage renal disease that take into account not only the metabolic derangement but also the effect of the dialysis treatment itself on the gain and loss of nutrients. In addition, the relationship between nutritional intake and the “dose” of dialysis is becoming clearer. Increasing experience in pediatric dialysis is enabling better selection of the mode of dialysis for children of different ages. The realization that the permeability of the peritoneal membrane is different from individual to individual has led to customized dialysis prescriptions with a consequent increase in the efficacy of peritoneal dialysis. When combined with improvements in therapy of medical complications of chronic renal failure, including the availability of synthetic erythropoetin and growth hormone and the management of renal osteodystrophy, dialysis is becoming a fully-functional tool in the management of children with end-state renal disease.

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References

  1. Bergstrom J. Nutrition and mortality in hemodialysis.J Am Soc Nephrol 1995; 6: 1329–1341.

    PubMed  CAS  Google Scholar 

  2. Depner TA. Prescribing hemodialysis: a guide to urea modeling. Boston, Dordrecht London: Kluwer Academic Publishers. 1991.

    Google Scholar 

  3. Teehan BP, Churchill DN, Kopple JD, Kohaut EC. Nutrition in peritoneal dialysis patients. In: International Society for Peritoneal Dialysis (U.S.), editor, Proceedings of the Status of Peritoneal Dialysis in the US. 1996; May 6–7: Bethesda M.D.Perit Dial Int. 1997; 17 (Suppl 3): 58–59.

  4. Chesney RL, Friedman L.A. The medical management of chronic renal failure. In: Tune M, Mendoza SA (eds)Contemporary Issues in Nephrology: Pediatric Nephrology, New York, Edinburgh, London, Melbourne: Churchill Livingstone; 1984; p. 332.

    Google Scholar 

  5. Warady BA, Kriley M, Lovell H, Farrell SE, Hellerstein S. Growth and development of infants with end-stage renal disease receiving long-term peritoneal dialysis.J Pediatr 1988; 112 (5): 714–719.

    Article  PubMed  CAS  Google Scholar 

  6. Heimburger O, Bergstrom J, Lindholm B. Maintenance of optimal nutrition in CAPD.Kidney Int 1994; 46 (Suppl 8): 39–46.

    Google Scholar 

  7. Canepa A, Perfumo F, Carrea A, Menoni S, Trivelli A, Delucchi Pet al. Nutritional status in children receiving chronic peritoneal dialysis. In:Peritoneal Dialysis International. Proceedings of the ISPD ‘95-The VIIth Congress of the ISPD; 1995 June 18–21; Stockholm, Sweden, 1995; 16 (Suppl 1): 2–7.

  8. Kopple JD. Protein-energy malnutrition in maintenance dialysis patients (McCollum Award Lecture]. Presented at the American Society for Clinical Nutrition Annual Meeting; Washington, DC.Am J Clin Nutr; 1996: 1544–1557.

  9. Arnold WC, Danford D, Holliday MA. Effects of caloric supplementation on growth in children with uremia.Kidney Int 1983; 24: 205–209.

    Article  PubMed  CAS  Google Scholar 

  10. Rizzoni G, Broyer M, Guest G, Fine R, Holliday MA. Growth retardation in children with chronic renal disease: Scope of the problem.Am J Kidney Dis 1986; 7 (4): 256–261.

    PubMed  CAS  Google Scholar 

  11. Rissoni G, Basso T, Stari M. Growth in children with chronic renal failure on conservative treatment.Kidney Int 1984; 26 (1): 52–28.

    Article  Google Scholar 

  12. Pollock CA, Ibels LS, Allen BJ. Nutritional markers and survival in maintenance dialysis patients.Nephron 1996; 74: 625–641.

    Article  PubMed  CAS  Google Scholar 

  13. Depner TA. Optimizing the treatment of the dialysis patient: A painful lesson.Semin Nephrol 1997; 17 (4): 285–297.

    PubMed  CAS  Google Scholar 

  14. Lowrie EG, Laird NM, Parker RF, Sargent JA. Effect of the hemodialysis prescription of patient morbidity: Report from the National Cooperative Dialysis Study.N Engl J Med 1981; 305 (20): 1176–1181.

    Article  PubMed  CAS  Google Scholar 

  15. Lindsay RM, Spanner E. A hypothesis: the protein catabolic rate is dependent upon the type of and amount of treatment in dialyzed uremic patients.Am J Kidney Dis 1989; 13 (5): 382–389.

    PubMed  CAS  Google Scholar 

  16. Warady B, Watkins SL. Current advances in the therapy of chronic renal failure and end stage renal disease.Semin Nephrol 1998; 18 (3): 341–354.

    PubMed  CAS  Google Scholar 

  17. Gemma SL, Kalia A. Nutritional management of infants on continuous peritoneal dialysis.J Pediatr and Perinal Nutr 1987; 1: (2): 19–34.

    CAS  Google Scholar 

  18. Nea AM, Warady BA. Dialysis and renal transplantation in infants with irreversible renal failure.Adv Ren Repl Ther 1996; 3 (1): 48–59.

    Google Scholar 

  19. Brewer ED. Growth of small children managed with chronic peritoneal dialysis and nasogastric tube feedings: 203 month experience in 14 patients.Adv Perit Dial 1990; 6: 269–272.

    PubMed  CAS  Google Scholar 

  20. Quan A, Baum M. Protein losses in children on continuous cycler peritoneal dialysis.Pediatr Nephrol 1996; 10: 278–731.

    Article  Google Scholar 

  21. Salusky IB. Nutritional management of pediatric patients on chronic dialysis. In: Nissenson AL, Fine RN, Gentile DE, (eds)Clinical Dialysis Norwalk, CT Appleton and Lange 1995: p 537.

    Google Scholar 

  22. Blumenkrantz MJ, Gahl GM, Kopple JD, Kamdar AV, Jones MR, Kessel Met al. Protein losses during peritoneal dialysis.Kidney Int. 1981; 19 (4): 593–602.

    Article  PubMed  CAS  Google Scholar 

  23. Makoff RK. Inadequate intake combined with unique requirements mandate speciality vitamin supplementation for renal failure patients.Contemp Dial and Nephrol 1998; 28–30.

  24. Bergstrom J. Acidosis in end-stage renal failure: Metabolic acidosis and nutrition in dialysis patients.Blood Purif 1995; 13: 361–367.

    PubMed  CAS  Google Scholar 

  25. Kohaut EC. Nutrition in the pediatric ESRD patient on peritoneal dialysis In: International Society for Peritoneal Dialysis (U.S.) editor. Proceedings of the Status of Peritoneal Dialysis in the U.S.; 1996 May 6–7; Bethesda, MDPerit Dial Int 1997; 17 (Suppl 3): p S67–S68.

  26. Sliman GA, Klee KM, Gall-Holden B, Watkins SL. Peritoneal equilibration test curves and adequacy, of dialysis in children on automated peritoneal dialysis.Am J Kidney Dis 1994; 24 (5): 813–818.

    PubMed  CAS  Google Scholar 

  27. Nelson P, Stover J. Nutrition recommendations for infants, children, and adolescents with end-stage disease. In:A Clinical Guide to Nutrition Care in End-stage Renal Disease. The American Dietetic Assn (publisher) 1994: p 79–97.

  28. Bunchman TE. Chronic dialysis in the infant less than 1 year of age.Pediatr Nephrol 1995; 9: S18-S22.

    Article  PubMed  Google Scholar 

  29. Warady BA, Weis L, Johnson L. Nasogastric tube feeding in infants on peritoneal dialysis.Perit Dial Int 1996; 16 (Suppl 1): S521-S525.

    PubMed  Google Scholar 

  30. Kamen RS. Imparied development of oralmotor functions required for normal oral feedings as a consequence of tube feeding during infancy.Adv Perit Dial 1990; 6: 276–278.

    PubMed  CAS  Google Scholar 

  31. Wolfson M, Shuter C. Nutrition in patients with chronic renal failure and patients on dialysis. In: Nissenson AL, Fine RN, Gentile DE, (eds).Clinical Dialysis. Norwalk, CT: Appleton and Lange; 1995: p 523.

    Google Scholar 

  32. Chertow GM, Bullard A, Lazarus JM. Nutrition and the Dialysis Prescription.AM J Nephrol 1996; 16: 79–89.

    PubMed  CAS  Google Scholar 

  33. Ikizler TA, Schulman G. Adequacy of dialysis.Kidney Int 1997: 52 (Suppl 62): 96–100.

    Google Scholar 

  34. Teehan BP, Schleifer CR, Brown J. Adequacy of continuous ambulatory peritoneal dialysis: Morbidity and mortality in chronic peritoneal dialysis.AM J Kidney Dis 1994; 24 (6): 990–1001.

    PubMed  CAS  Google Scholar 

  35. Keshaviah PR, Nolph KD, Van Stone JC. The peak concentration hypothesis: a urea kinetic approach to comparing the adequacy of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis.Perit Dial Int 1989; 9(4): 257–260.

    PubMed  CAS  Google Scholar 

  36. Lindsay RM and Henderson LW. Adequacy of dialysis.Kidney Int 1988;33 (Suppl 24): S92-S99.

    Google Scholar 

  37. Schreiber MJ. Membrane viability in the long-term peritoneal dialysis patient.Perit Dial Int 1997; 17 (Suppl 3): S19-S24.

    PubMed  Google Scholar 

  38. Salusky IB and Holloway M. Selection of peritoneal dialysis for pediatric patients. In: International Society for Peritoneal Dialysis (U.S.), editor. Proceedings of the Status of Peritoneal Dialysis in the U.S. 1996 May 6–7; Bethesda, MD.Perit Dial Int 1996; 17 (Suppl 3): p S35–S37.

    Google Scholar 

  39. Brownbridge G and Fielding DM. Psychosocial adjustment and adherence to dialysis treatment regimes.Pediatr Nephrol 1994; 8: 744–749.

    Article  PubMed  CAS  Google Scholar 

  40. Brem AS, Brem FS, McGrath M, Spirito A. Psychosocial characteristics and coping skills in children maintained, on chronic dialysis.Pediatr Nephrol 1988; 2: 460–465.

    Article  PubMed  CAS  Google Scholar 

  41. Yalcinkaya F, Tumer N, Cakar N, Ozakaya N. Low-dose erythropoietin is effective and safe in children on continuous ambulatory peritoneal dialysis.Pediatr Nephrol 1997; 11: 350–352.

    Article  PubMed  CAS  Google Scholar 

  42. Ongkingco JR, Ruley EJ, Turner ME, Fragale MR. Efficacy of once-versus thrice weekly subcutaneous recombinant human erythropoietin in children receiving continuous cycling peritoneal dialysis.Am J Nephrol 1994; 14: 14–18.

    PubMed  CAS  Google Scholar 

  43. Mohini R. Clinical efficacy of recombinant human erythropoietin in hemodialysis patients.Semin Nephrol 1989; 9(1): 16–21.

    PubMed  CAS  Google Scholar 

  44. Fine RN. Recombinant human growth hormone treatment of children with chronic renal failure: Update 1990.Acta Pediatr Scand 1990; 370 (Suppl): 44–48.

    CAS  Google Scholar 

  45. Maxwell H and Rees L. Recombinant human growth hormone treatment in infants with chronic renal failure.Arch Dis Child 1996; 74: 40–43.

    PubMed  CAS  Google Scholar 

  46. Fine RN. Growth hormone treatment of children with chronic renal insufficiency, end-stage renal disease and following renal transplantation—Update 1997.J Pediatr Endocrinol Metab 1997; 10: 361–370.

    PubMed  CAS  Google Scholar 

  47. Salusky IB and Goodman WG. The management of renal osteodystrophy.Pediatr Nephrol 1996; 10: 651–655.

    Article  PubMed  CAS  Google Scholar 

  48. Armstrong A and Cunningham J. The treatment of metabolic bone disease in patients on peritoneal dialysis.Kidney Int 1994; 46(Suppl 48): S51-S57.

    Google Scholar 

  49. Salusky IB, Foley J, Nelson P, Goodman WG. Aluminum accumulation during treatment with aluminum hydroxide and dialysis in children and young adults with chronic renal disease.N Engl J Med 1991; 324(8): 527–531.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of Texas Medical Branch at Galveston, 301 University Blvd. Galveston, 77555-0373, Texas, USA

    Alok Kalia

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  1. Alok Kalia
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Kalia, A. Dialysis therapy in end-stage renal disease. Indian J Pediatr 66, 255–262 (1999). https://doi.org/10.1007/BF02761216

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