Document Detail


Outcome data on pediatric dialysis patients from the end-stage renal disease clinical indicators project.
MedLine Citation:
PMID:  10922309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Network 1 (New England) initiated the Clinical Indicator Project to survey dialysis adequacy (Kt/V), nutrition (serum albumin level), and anemia management in patients maintained on chronic dialysis. Because little information is available in children, data were specifically recorded covering these variables in patients (age, 1 to 18 years) maintained on either hemodialysis (HD) or peritoneal dialysis (PD). During the 18 months of data collection, 29 observations were recorded on 23 HD patients (age, 14.3 +/- 3.6 years), and 43 observations were made on 30 PD patients (age,10.6 +/- 4.7 years). Kt/V correlated inversely with the age of the patient (HD, P < 0.004; PD, P < 0.0007). Although serum albumin level was not associated with dialysis adequacy in HD patients, there was a strong inverse relationship between albumin level and Kt/V in PD patients (P < 0.002). Hematocrit values were not significantly different in the two groups (HD, 31.0% +/- 5.5% versus PD, 32.9% +/- 4.8%) and could not be correlated with weekly erythropoietin dose. Weekly erythropoietin dose was directly related to patient age in both groups (HD, P < 0.05; PD, P < 0.02). The weekly erythropoietin dosage needed to maintain the hematocrit was greater in HD patients (HD, 11,211 +/- 7,484 U versus PD, 3,790 +/- 1,968 U; P < 0.0001). We conclude that (1) smaller children in both groups tend to have a greater Kt/V, (2) Kt/V greater than 2.75 in PD patients may not improve nutrition per se and could result in increased albumin losses, and (3) erythropoietin dosing appears to correlate best with patient size (age) rather than degree of anemia.
Authors:
A S Brem; C Lambert; C Hill; J Kitsen; D G Shemin
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  36     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-08-28     Completed Date:  2000-08-28     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  310-7     Citation Subset:  IM    
Affiliation:
Division of Pediatric and Adult Nephrology, Brown University, Providence, RI, USA. andrew_brem@brown.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anemia / blood,  etiology,  therapy
Child
Child, Preschool
Creatinine / metabolism
Erythropoietin, Recombinant / administration & dosage
Hematocrit
Humans
Infant
Kidney Failure, Chronic / complications,  metabolism,  therapy*
Nutritional Status
Outcome Assessment (Health Care)
Peritoneal Dialysis* / adverse effects
Renal Dialysis* / adverse effects
Serum Albumin / analysis
Urea / metabolism
Grant Support
ID/Acronym/Agency:
500-97-E019//PHS HHS
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Serum Albumin; 57-13-6/Urea; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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