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ESRD pediatric guidelines

Ari H Pollack, Assaf P Oron, Joseph T Flynn, Raj Munshi
BACKGROUND: Erythropoietin-stimulating agent hyporesponsiveness (ESAH) is associated with increased cardiovascular mortality in patients with end-stage renal disease (ESRD) on hemodialysis. Dynamic treatment regimes (DTR), a clinical decision support (CDS) tool that guides the prescription of specific therapies in response to variations in patient states, have been used to guide treatment for chronic illnesses that require frequent monitoring and therapy changes. Our objective is to explore the role of utilizing a DTR to reduce ESAH in pediatric hemodialysis patients...
April 4, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Pornpimol Rianthavorn, Manunya Chacranon
BACKGROUND: Information on long-term renal outcome of pediatric glomerulonephritis associated with crescent formation is limited. A single center retrospective study was conducted to assess long-term renal survival and to determine whether the 2010 classification for antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis can predict renal outcome in pediatric glomerulonephritis associated with crescent formation. METHODS: Biopsy and clinical data of children, aged ≤ 18 years with ≥ 10 glomeruli and ≥ 10% crescentic glomeruli during January 1998 to December 2015, were reviewed...
November 3, 2017: Clinical and Experimental Nephrology
Ashraf Galal, Fatina I Fadel, Enas Mokhtar, Manal F Elshamaa, Eman A Elghoroury, Solaf Kamel, Gamila S M Elsaeed, Eman H Thabet
BACKGROUND AND OBJECTIVES: Data concerning the concentration of matrix metalloproteinase-9 (MMP-9) and its functional polymorphisms in chronic kidney diseases (CKD) are conflicting. The present study aimed to evaluate the levels of MMP-9in children with end stage renal diseases (ESRD) on hemodialysis (HD) and to explore its association with MMP-9 polymorphism and vitamin D levels as an important risk factors for cardiovascular diseases (CVD). METHODS: We studied 55 children with ESRD on hemodialysis and 18 healthy children served as controls...
September 2016: International Journal of Biomedical Science: IJBS
Cindy Richards
Pediatric patients with end stage renal disease (ESRD) are not as prevalent as adults with ESRD, but the numbers are increasing each year. Medical management is the same for pediatric patients as it is with adults with ESRD: hemodialysis, peritoneal dialysis, no therapy, or transplantation. Among most pediatric nephrology centers, the goal for patients is to achieve transplantation.
January 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Ying Liang, Ning Sun, Hui Wang, Ying Shen
OBJECTIVE: To analyze the factors relevant to success rate of arteriovenous fistula (AVF) plasty in children who need maintenance hemodialysis and to provide predictor of the success of operation. METHOD: Totally 62 patients who had arteriovenous fistula plasty operation for maintenance of hemodialysis in our hospital treated during June 2007 to April 2014 were enrolled into this study, 41 were male, and 21 female, median age of surgery was 11 years and 9 months (age range was 5 y 8 m to 16 y 2 m)...
September 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Aicha Merouani, Michel Lallier, Julie Paquet, Johanne Gagnon, Anne Laure Lapeyraque
BACKGROUND: The choice of vascular access (VA) for hemodialysis (HD) in end-stage renal disease (ESRD) is arteriovenous fistula (AVF) or central venous catheter (CVC). Whereas clinical practice guidelines suggest AVF to preserve the vascular bed, pediatric nephrologists tend to favor CVC for shorter-term dialysis. Our objective was to determine whether pediatric priority allocation policies for deceased-donor kidneys affect VA planning. METHODS: Pediatric priority for deceased-donor kidneys was instituted in Quebec in 2004...
December 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ronald J Hogg
This review addresses the relevance of urinary screening for chronic kidney disease (CKD) in children. Ambiguity about screening children exists because of the uncertainty as to whether early detection of renal disorders in childhood will lead to effective interventions and reduction in the number of individuals who subsequently progress to ESRD. A related concern is whether the adoption of urinary screening programs is cost effective. The most common method that is used for screening children for CKD involves the measurement of spot samples of urine for hematuria and or proteinuria...
February 2009: Clinical Journal of the American Society of Nephrology: CJASN
Alicia M Neu, Diane L Frankenfield
Although prospective randomized trials have provided important information and allowed the development of evidence-based guidelines in adult hemodialysis (HD) patients, with approximately 800 prevalent pediatric HD patients in the United States, such studies are difficult to perform in this population. Observational data obtained through the Center for Medicare & Medicaid Services' (CMS') End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) Project have allowed description of the clinical care provided to pediatric HD patients as well as identification of risk factors for failure to reach adult targets for clinical parameters such as hemoglobin, single-pool Kt/V (spKt/V) and serum albumin...
July 2009: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jeffrey J Fadrowski, Diane Frankenfield, Sandra Amaral, Tammy Brady, Gregory H Gorman, Bradley Warady, Susan L Furth, Barbara Fivush, Alicia M Neu
BACKGROUND: The Centers for Medicare & Medicaid Services End-Stage Renal Disease Clinical Performance Measures (CPM) Project contains one of the largest databases of prevalent pediatric dialysis patients in the United States. Since 2005, the CPM Project has included not only children on long-term hemodialysis (HD) therapy, but also those on long-term peritoneal dialysis (PD) therapy. This study describes demographic and clinical characteristics and compares them between patients on HD and PD therapy...
December 2007: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Walter H Hörl
Iron deficiency is the most common cause of hyporesponsiveness to erythropoiesis-stimulating agents (ESAs) in end-stage renal disease (ESRD) patients. Iron deficiency can easily be corrected by intravenous iron administration, which is more effective than oral iron supplementation, at least in adult patients with chronic kidney disease (CKD). Iron status can be monitored by different parameters such as ferritin, transferrin saturation, percentage of hypochromic red blood cells, and/or the reticulocyte hemoglobin content, but an increased erythropoietic response to iron supplementation is the most widely accepted reference standard of iron-deficient erythropoiesis...
April 2007: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Rulan S Parekh, Samuel S Gidding
Mortality from end-stage renal disease (ESRD) is often due to cardiac causes. Although cardiovascular complications of ESRD have long been recognized, only recently has the presence of traditional cardiovascular risk factors been associated with late cardiovascular complications. This review presents a history of cardiac involvement in ESRD, the pathophysiology of accelerated atherosclerosis and left ventricular hypertrophy, and a summary of the literature on cardiovascular risk assessment in children. Techniques for non-invasive assessment of cardiac end-organ injury are also discussed...
February 2005: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Fabio Paglialonga, Susanna Esposito, Alberto Edefonti, Nicola Principi
Infectious complications of the central venous catheter (CVC) are a major source of morbidity among children treated with hemodialysis (HD), with catheter-related bloodstream infections (CRBSI) being the most important clinical manifestations. As only a few studies of children on HD have been published, the management of CVC-related infections in this population is mainly based on data derived from adults or occasionally from children not affected by end-stage renal disease (ESRD). The aim of this review is to discuss current knowledge concerning the epidemiology, prevention, and treatment of catheter-related infections in children on HD...
December 2004: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Rita D Swinford, Ronald J Portman
Hypertension, as in adults, is a frequent complication found in children with chronic kidney disease (CKD). Indeed, hypertension has now become one of the most prevalent chronic diseases of childhood. The most recent data available (2003) indicate that at least 38% of children with CKD in the United States are receiving antihypertensive therapy. Only recently has it been shown in children that hypertension, traditionally considered a marker for disease severity in children, is additionally a significant and independent risk factor for accelerated deterioration of kidney function and progression of CKD and a significant risk factor for cardiovascular disease...
April 2004: Advances in Chronic Kidney Disease
A S Brem, C Lambert, C Hill, J Kitsen, D G Shemin
The Health Care Financing Administration (HCFA) has gathered clinical data on end stage renal disease (ESRD) patients since 1994, but details are only available on patients >/=18 years. In this report, we present morbidity data collected prospectively over 12 months from all children (1-18 years) maintained on either hemodialysis (HD) or peritoneal dialysis (PD) within the six-state New England area. During this year, 17 observations were recorded on 14 HD patients (age 13.4+/- 11.3 years) and 36 observations were made on 25 PD patients (age 11...
November 2001: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
V Chadha, B A Warady
The efficacy of peritoneal dialysis in terms of the clearance of small molecules such as urea and creatinine is referred to as "adequacy." Treatment guidelines and adequacy targets have been developed and distributed by the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) in an effort to reduce variations in end-stage renal disease (ESRD) treatment. Much effort has been made to determine the correlation between dialysis dose and various clinical outcome measures (eg, hospitalization, mortality) in adults in an attempt to define the optimal dialysis dose...
September 2001: Seminars in Nephrology
I Riaño, S Malaga, L Callis, C Loris, J Martin-Govantes, M Navarro, A Vallo
There are few data describing the current practices of treatment selection for children with end-stage renal disease (ESRD). In an effort to establish a consensus among Spanish pediatric nephrologists for inclusion and exclusion criteria for renal replacement therapy in children with ESRD, in 1995 we surveyed members of the Spanish Pediatric Nephrology Association. Although only 43% of members responded, pediatric nephrologists and bioethicists studied the results and compiled a list of ten guidelines for treatment of children with ESRD...
November 2000: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
K Jabs, B A Warady
The National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Guidelines for hemodialysis and peritoneal dialysis adequacy, management of vascular access, and management of anemia are based primarily on evidence derived from the experience of adult dialysis patients. However, these Guidelines can also be used to improve the care of children with end-stage renal disease (ESRD). Some of the guidelines are directly applicable to pediatric dialysis patients, such as the preferential use of the internal jugular vein for placement of a central venous catheter for dialysis...
January 1999: Advances in Renal Replacement Therapy
I Riaño Galán, S Málaga Guerrero
OBJECTIVE: The purpose of this study was to know the current practices of Spanish pediatric nephrologists concerning the inclusion or not of children with end-stage renal disease (ESRD) in programs of dialysis and transplantation in order to open a discussion on the topic that would allow a consensus to be reached. PATIENTS AND METHODS: A descriptive and prospective study using an anonymously mailed survey to 90 members of the Spanish Pediatric Nephrology Association was carried out...
January 1998: Anales Españoles de Pediatría
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