When a child’s kidneys do not work like it is supposed to, they need to receive dialysis which is a blood filtering treatment. Dialysis helps the body to filter waste and extra fluid since the kidneys cannot do this properly or not at all. There are specialised children dialysis centres all over the world to provide treatment to children of all ages. Often most children with a kidney disease will have a kidney transplant once they are big enough, so until then they will need to get dialysis treatment.

Types of Dialysis

There are two types of dialysis namely Haemodialysis and Peritoneal dialysis.

Haemodialysis is a type of dialysis treatment where a dialyzer filter is used to remove waste and extra fluids from the blood. A haemodialysis machine is used which has a dialyzer connected to it which allows the blood to filter out the waste and fluids. The haemodialysis machine has a good monitor system which allows the blood to flow at a pace it should. This kind of machine also ensures to keep the blood pressure under control and to help the body keep a good balance of all the minerals which it needs.[1]

This type of dialysis treatment takes place at a dialysis centre which usually takes up to three to five hours a day. When it comes to dialysis treatment for children, the treatment takes place very regularly for example, every second day.

The Peritoneal dialysis treatment is when the lining of the abdominal cavity is used to filter the blood. The lining is called the peritoneum. Dialysis solution which is a type of salt water, is emptied from a plastic bag through a catheter into the abdominal cavity. Once the dialysis solution is in inside the body, it soaks up all the waste and extra fluids and afterwards gets drained from the body into another bag which removes the waste and fluids from the body. This process takes about 30 minutes. Before peritoneal dialysis treatment starts, a catheter needs to be placed into the child’s stomach.[2]

Peritoneal dialysis is usually the best choice of dialysis treatment for children. It’s mild and can be done overnight while they are sleeping.

Dialysis at Home

There is a possibility for certain dialysis centres to explain to a child’s parents or carers how they can do the haemodialysis treatment at home without the presence of a dialysis nurse. This allows the treatment to take place more often due to flexibility at home. Because of the frequent treatment, the affect is similar to which it would be if the kidneys worked without failure. This type of training for parents and carers take up to one till two months.[3]

Diet during Dialysis Treatment

A child’s diet plays an important role during dialysis treatment since it can affect how well the treatment work and how much waste and fluids are to be removed. Children on dialysis treatment should eat more protein and limit some foods that are high in phosphorus and sodium. Since many high-protein foods are also high in phosphorus, it is important for the parent and carers to consult a dietitian to help plan the right diet for the child. Children on dialysis treatment also need a special vitamin supplement to replace the vitamins which they lose during the treatment.[4]

Parents or carers should always consult with their child’s treatment team before making any changes to the child’s diet.

Catheter Access

A central venous catheter is only a temporary method to have haemodialysis treatment. This is a flexible y-shaped tube that makes its way through the child’s skin into a central vein in their neck, chest or upper leg. [5] This method can be used while the fistula or graft is healing.

The fistula is a surgical connection made between an artery and a vein. This is mostly done in the arm and can also be done in the leg. This type of catheter access allows a bigger blood flow percentage through the vein, which helps expand and strengthen the vein.[6] This treatment allows a cycled blood flow from the vein to a dialysis machine.

A graft works in a similar way as a fistula. If a patient has blocked or damaged veins, or veins that are too small for a fistula, it is better to make use of the graft. The placement procedure is similar to that of the fistula, but with the graft, the artery is directly connected to the vein, one end of a small tube will be connected to the vein, and the other end will be connected to the artery.[7]

Kidney Transplantation

When children have kidney transplants, it often comes with complications like infection, organ rejection or some types of cancer. It could also be the case that they will need treatment to help with the rate they are growing. To try and avoid the organ rejection, the child should take immunosuppressive medication which helps prevent the body from making antibodies. Due to this type of medication, the child is often exposed to infections or the body may not respond like it should to vaccines. Another affect of the medication could be the development of some kind of cancer which could develop in different parts of the body.[8]

Keywords: Children Dialysis, Haemodialysis, Peritoneal Dialysis, Home Dialysis

 

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Sources:

[1] https://www.niddk.nih.gov/health-information/kidney-disease/children/treatment-kidney-failure

[2] [3] https://www.niddk.nih.gov/health-information/kidney-disease/children/treatment-kidney-failure

[4] https://www.kidney.org/atoz/content/nutrichild

[5] https://medlineplus.gov/ency/article/007641.htm

[6] [7] https://www.azuravascularcare.com/infodialysisaccess/types-of-dialysis-access/

[8] https://www.niddk.nih.gov/health-information/kidney-disease/children/treatment-kidney-failure

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