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Haemodiafiltration use in children: data from the Italian Pediatric Dialysis Registry

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Abstract

Background

High volume haemodiafiltration (HDF) is associated with better survival than conventional haemodialysis (HD) in adults, but data concerning its use in children are lacking. The aim of this study was to assess the prevalence of paediatric HDF use and its associated factors in recent years in Italy.

Methods

We retrospectively reviewed the files of patients from the Italian Pediatric Dialysis Registry’s database who were registered between January 1, 2004 and December 31, 2016 and treated with extracorporeal dialysis for at least 6 months, looking in particular at modality and its associated factors.

Results

One hundred forty-one out of 198 patients were treated exclusively with bicarbonate HD (71.2%), 57 with HDF (28.8%). Patients treated with HDF were younger (median 9.7 vs 13.2 years, p = 0.0008), were less often incident patients (52.6% vs 75.9%, p = 0.0031), had longer duration of the HD cycle (26.9 vs 20.8 months, p = 0.0036) and had a longer time to renal transplantation (32 vs 25 months, p = 0.0029) than those treated with bicarbonate HD only. The percentage of patients treated with HDF increased with dialysis vintage (16.9% at 6 months, 38.1% after more than 2 years of dialysis). The use of HDF was stable over time and was more common in the largest centres.

Conclusions

Over the observation period, HDF use in Italy has been limited to roughly a quarter of patients on extracorporeal dialysis, in particular to those with high dialysis vintage, younger age or a long expected waiting time to renal transplantation.

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Author information

Authors and Affiliations

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

    Fabio Paglialonga, Silvia Consolo, Giovanni Pieri, Giovanni Montini & Alberto Edefonti

  2. Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women’s and Children’s Health, University-Hospital, Padua, Italy

    Enrico Vidal & Luisa Murer

  3. Nephrology and Dialysis Unit, Santobono Children’s Hospital, Naples, Italy

    Carmine Pecoraro

  4. Nephrology and Dialysis Unit, Department of Pediatrics, “Bambino Gesù” Children’s Hospital-IRCCS, Rome, Italy

    Isabella Guzzo

  5. Nephrology Division and Dialysis Unit, Giovanni XXIII Children’s Hospital, Bari, Italy

    Mario Giordano

  6. Nephrology Dialysis and Transplantation Unit, Regina Margherita University Hospital, Turin, Italy

    Bruno Gianoglio

  7. Pediatric Nephrology and Dialysis Unit, Children’s Hospital G. Di Cristina, Palermo, Italy

    Ciro Corrado

  8. Nephrology and Dialysis Unit, Meyer Children’s Hospital, Florence, Italy

    Rosa Roperto

  9. University Department of Pediatrics, United Hospitals of Ancona, Ancona, Italy

    Ilse Ratsch

  10. Dialysis Unit, Paediatric Nephrology and Dialysis Department, G Gaslini Children Hospital, Genoa, Italy

    Salvatore Luzio & Enrico Verrina

Authors
  1. Fabio Paglialonga
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  2. Enrico Vidal
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  14. Giovanni Montini
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Correspondence to Fabio Paglialonga.

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Paglialonga, F., Vidal, E., Pecoraro, C. et al. Haemodiafiltration use in children: data from the Italian Pediatric Dialysis Registry. Pediatr Nephrol 34, 1057–1063 (2019). https://doi.org/10.1007/s00467-018-4184-z

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  • DOI: https://doi.org/10.1007/s00467-018-4184-z

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