Kaur Amrit, Davenport Andrew
Birmingham Childrens' Hospital, Birmingham, UK.
Hemodial Int. 2014 Jul;18(3):573-82. doi: 10.1111/hdi.12163. Epub 2014 Apr 14.
Children with chronic kidney disease stage 5 requiring dialysis can be treated by peritoneal or hemodialysis. In the United Kingdom nearly twice as many children receive peritoneal dialysis compared with hemodialysis. Technical aspects of pediatric hemodialysis are challenging and include the relative size of extracorporeal circuit and child's blood volume, assessment of adequacy,technical and complications of vascular access. Alternatives to standard hospital-based hemodialysis are also increasingly available. Optimizing nutritional status with the support of specialist pediatric dietitians is key to the management of children receiving hemodialysis. The effects of chronic illness on growth and school achievement, as well as the psychological, emotional, and social development of the child should not be underestimated. This review focuses on the above elements and highlights common pediatric practice in the United Kingdom.
需要透析的5期慢性肾病儿童可采用腹膜透析或血液透析进行治疗。在英国，接受腹膜透析的儿童人数几乎是接受血液透析儿童人数的两倍。小儿血液透析的技术层面具有挑战性，包括体外循环与儿童血容量的相对大小、充分性评估、血管通路的技术及并发症。以医院为基础的标准血液透析的替代方案也越来越多。在专业儿科营养师的支持下优化营养状况是接受血液透析儿童管理的关键。慢性病对生长发育和学业成绩的影响，以及儿童的心理、情感和社会发展都不应被低估。本综述聚焦于上述要点，并突出了英国常见的儿科实践。
