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Younger patients may receive more intense hemodialysis treatment
Compared with adolescents and young adults who are overweight, results published in Nephrology Dialysis Transplantation showed children aged 12 years or younger may receive more intense hemodialysis treatment.
Researchers calculated median individual hemodialysis prescriptions per year among 1,852 patients 30 years of age or younger on chronic hemodialysis from childhood and who received thrice weekly outpatient hemodialysis between 2004 and 2016. Researchers also derived overall 50% and 90% distribution ranges over age and weight, and assessed differences between age and weight groups through repeated measurement analysis of variance.
Results showed significant differences in prescriptions among age and weight groups. Researchers found higher weight-normalized blood flow rate, urea dialytic clearance and single pool Kt/V among patients with a lower weight vs. heavier weight. Compared with adults and children younger than 12 years of age, researchers noted a significantly lower blood flow rate, urea dialytic clearance and single pool Kt/V among adolescents. Urea dialytic clearance was underpredicted by dialytic clearance derived from a mechanistic equation in children, but not young adults. Researchers observed significant growth retardation, with a decrease from 71% to 15% in a proportion of patients in less than the third percentile.
“Observed age- and size-related differences in [hemodialysis] HD prescription and delivery may have implications not only for clinical outcomes, but also for urea and middle molecule kinetic assessment and modeling, as well as for drug removal and dose adjustment, deserving further investigations,” the authors wrote. “Provided ranges of outpatient HD prescription can help clinicians and researchers in designing studies as well as personalizing and optimizing delivery of dialysis treatment.” – by Casey Tingle
Disclosures: Gotta reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.