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Journal of the Korean Society of Pediatric Nephrology 2007;11(1): 41-50. doi: https://doi.org/10.3339/jkspn.2007.11.1.41
2세 미만 만성 신부전 환아에서의 만성 투석
손영배, 남숙현, 곽민정, 김수진, 진동규, 백경훈
1성균관대학교 의과대학 소아과학교실
2성균관대학교 의과대학 소아과학교실
3성균관대학교 의과대학 소아과학교실
4성균관대학교 의과대학 소아과학교실
5성균관대학교 의과대학 소아과학교실
6성균관대학교 의과대학 소아과학교실
Chronic Dialysis in Infants and Children Under 2 Years of Age
Young-Bae Sohn, Sook-Hyun Nam, Min-Jung Kwak, Su-Jin Kim, Dong-Kyu Jin, Kyung-Hoon Paik
1Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
2Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
3Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
4Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
5Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
6Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University
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ABSTRACT
Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases.
Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007.
Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis.
Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function.
Key words: Chronic dialysis | Peritoneal dialysis | Hemodialysis | Infant
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