Hemodialysis for infants, children, and adolescents

Kaur, Amrit; Davenport, Andrew

doi:10.1111/hdi.12163

Cited by 24 publications

(20 citation statements)

References 40 publications

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“…Therefore, this group stand to benefit the most from a maximised nutritional state. Data are lacking regarding intradialytic oral nutritional supplementation in these patients, who are especially at risk of malnutrition (Kopple ; Kaur & Davenport ). Many studies have investigated the use of intradialytic parenteral nutrition, wherein adverse effects such as emesis are uncommon (Krause et al ).…”

Section: Discussionmentioning

confidence: 99%

“…Children and young people undergoing dialysis frequently require supplemental food to improve their nutritional status (Zioni ; KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: Update 2009; Kaur & Davenport ). Sufficient nutrition is difficult for paediatric patients to obtain.…”

Section: Introductionmentioning

confidence: 99%

“…Historically, patients were not allowed to eat when having HD given the theoretical risks of adverse effects related to differential blood flow away from the splanchnic blood vessels, decreased dialysis efficiency, and an increased risk of choking/aspiration (Christner & Riley ; Kistler et al , ). This is especially true in children on dialysis (Kaur & Davenport ). However this clinical practice arose from anecdotal reports, and the actual prevalence of these adverse effects is quite low (Christner & Riley ; Kistler et al ).…”

Section: Introductionmentioning

confidence: 99%

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Children tolerate intradialytic oral nutrition

South

Fainman²,

Sutherland

et al. 2017

Journal of Renal Care

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Background Haemodialysis (HD) patients have poor nutrition, which contributes to worse outcomes. Inadequate nutrition has a particularly deleterious effect on growth and neurocognitive development, as well as mortality, in children and adolescents. Nutritional supplementation can improve outcomes but can be difficult to administer. Objective Determine the tolerability of intradialytic oral nutrition in paediatric patients. Design Cross-sectional quality improvement study in an outpatient paediatric HD unit. Intervention was intradialytic oral nutritional supplementation provided as protein bars and/or meals. Subjects Children and adolescents on outpatient HD who were able to participate in surveys and eat by mouth. Measurements Adverse effects and symptoms on nurse- and patient-reported surveys, respectively. Relationships between the predictor variables and the outcomes were assessed using generalized estimating equations. Results The majority of children felt better after eating on dialysis (72%) with no adverse effects (80%). On unadjusted analyses and confirmed with generalized estimating equation modelling, children who reported being hungry felt better after eating on dialysis (OR 4.58, 95% CI 1.5 to 13.92, p = 0.007), despite being more likely to have adverse effects (2.42, 1.0 to 5.87, p = 0.05). Conclusion The study demonstrates that our paediatric HD patients feel better after eating on HD with minimal adverse effects. The finding that hungry patients are more likely to feel better despite having a higher likelihood of an adverse effect demonstrates the tolerability of eating on HD. Intradialytic oral nutrition could be a safe and well-tolerated opportunity to provide supplemental nutrition to paediatric HD patients and improve outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Children tolerate intradialytic oral nutrition

South

Fainman²,

Sutherland

et al. 2017

Journal of Renal Care

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“…Alternatively, some facilities increase hemodialysis to as often as six times per week for the youngest patients. Home hemodialysis is only available in a few centers in North America, but is another option to allow for liberalization of enteral feeding as typically blood pressure, clearance and serum potassium are improved with more frequent dialysis (34). …”

Section: Factors Affecting Enteral Nutrition Choicesmentioning

confidence: 99%

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

Nelms

2018

Front. Pediatr.

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Growth in pediatric Chronic Kidney Disease is important for long-term outcomes including final adult height and cognitive function. However, there are many barriers for children with chronic kidney disease to achieve adequate nutritional intake to optimize growth. This review highlights these unique concerns, including route of nutrition, dialysis contributions and biochemical indices. Fitting the enteral feeding to the patients' needs involves choosing an appropriate product or products, limiting harmful nutrients in excess, notably aluminum, and altering for electrolyte and micronutrient needs. Unique adjustments to the enteral regimen include accommodating volume needs, optimizing macronutrient ratios, specific electrolyte adjustments, the blending of products together, and adjustments made to consider patient and family psychosocial needs. When a holistic approach to medical nutrition therapy is applied, taking the above factors into consideration, adequate intake for growth of the child with CKD is achievable.

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“…Os efeitos negativos gerados pela experiência da criança e adolescente em tratamento hemodialítico no desenvolvimento psicológico, emocional e social não devem ser subestimados, mas considerados no planejamento de apoio psicológico (Ferris, Miles, Seamon, 2016;Kaur, Davenport, 2014;Lopes, Ferraro, Koch, 2014).…”

Section: De Acordo Comunclassified

O adolescente lutando para que a hemodiálise não o defina: corporeidade, identidade e estigma

Mieto¹

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The adolescent with chronic renal insufficiency who undergoes hemodialysis, in addition to experiencing the psychic, physical and social changes inherent to adolescence, coexists with the intense impact on their lives resulting from the need to perform hemodialysis sessions to stay alive. The research aims to understand how the adolescent with chronic renal insufficiency experiences the hemodialytic treatment The study of qualitative approach used as methodological reference the Grounded Theory and as theoretical reference, the Symbolic Interactionism. The data were obtained through observation, genogram and ecomap and the interview using the Original Romance method that allowed the researcher to understand the subjective perception of the individual about his history. The comparative data analysis made it possible to identify two phenomena that compose the experience: "Having a disruptive experience" that expresses the experiences lived by the adolescent and are producers of a necessary reconstruction of the identity and "Reconfiguring the self" that represents the strategies undertaken to support the experience of self-annihilation. The articulation of these phenomena allowed us to identify the central category: "Struggling for hemodialysis not to define him", from which a new theoretical model is proposed. The results of the study were interpreted in the light of symbolic interactionism, and three central concepts emerged from this process: corporeity, identity, and stigma The theoretical model built provides theoretical subsidies for the planning of adolescent care in a highly technological environment.

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Hemodialysis for infants, children, and adolescents

Cited by 24 publications

References 40 publications

Children tolerate intradialytic oral nutrition

Children tolerate intradialytic oral nutrition

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

O adolescente lutando para que a hemodiálise não o defina: corporeidade, identidade e estigma

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