Abstract
Despite agreement among pediatric nephrologists that renal transplantation is the therapy of choice, successful transplantation is often impossible due to cytotoxic antibodies. Ten pts (mean age at onset HD 10.8 yrs) have been on maintenance HD for more than 4 yrs (mean duration 5.3 yrs). 8 pts. have undergone successful transplantation with grafts functioning less than six months. Vascular access, even in children of 8 kg, has been by fistula exclusively. Mean fistula survival in 9 pts has been 59.7 months although a tenth patient has required 19 access procedures over 6 yrs. Manifestations of osteodystrophy such as epiphyseal slipping, genu valgum and brown tumors have been observed in 8/10, often due to poor compliance with the medication regimen. Linear growth has been poor even when corrected for skeletal age, despite biochemical control of uremia and nutritional counseling. An additional complication has been hemochromatosis (serum ferritin 11,000) in one adolescent and elevated serum ferritins in seven other pts. Promoting psychosocial maturation and rehabilitation through the use of “group therapy” sessions have been successful in achieving full school attendance and realistic career planning in all patients.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johnson, V., Weiss, R., Greifer, I. et al. 1510 LONG TERM HEMODIALYSIS (HD) IN CHILDREN AND ADOLESCENTS. Pediatr Res 15 (Suppl 4), 695 (1981). https://doi.org/10.1203/00006450-198104001-01533
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-01533