Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial

3^rd International Conference on Nephrology & Therapeutics

June 26-27, 2014 Valencia Conference Centre, Valencia, Spain

Mohamed Khaled El Hatw, Fatina Fadel1 and Ramzy El Baroudy

Scientific Tracks Abstracts: J Nephrol Ther

Abstract :

I n rapid accelerated hemodialysis (R-AHD), blood partially recirculates from the venous (outflow) to the arterial (inflow) line through a recirculation line (R) to selectively increase the filter blood flow rate (BFR). R-AHDPR uses two blood pump segments at the patient segment of the arterial line and at (R). To determine the effectiveness of R-AHD with regard to increasing anticoagulation and dialysis efficiency, ten children with end-stage renal disease in two stages were studied: stage 1 with 10 routine heparin R-AHD, then 10 half-dose heparin R-AHD, then 145 routine heparin R-AHD sessions for 1 month and then routine heparin double needle hemodialysis (DNHD) for one month (control). In stage 2, the patients with 10 routine heparin-mixed AHDPR and DNHD sessions were dialyzed, then eight low-dose heparin R-AHDPR? sessions, then one of the children with 10 no-heparin R-AHDPR sessions and then 10 routine heparin DNHD sessions? (control). Signs of blood clotting and dialysis efficiency were monitored. Blood clots appeared in four out of 165 R-AHD0 (one pump circuit) sessions but in none of the 28 R-AHDPR sessions. In stage 1, the mean urea reduction rate was 0.60, 0.60 and 0.70 for the R-AHD protocols, compared with 0.71 for the control (P>0.05). In stage 2, the arterial blood urea nitrogen was reduced by 0.66±0.15 after an R-AHDPR period, compared with 0.79±0.18 after a DNHD period (P=0.059). In conclusion, R-AHDPR allowed successful low heparin and no heparin hemodialysis in children without increasing the patients? BFR. However, the technique did not increase the efficiency of dialysis.

Biography :

Mohamed Khaled El Hatw graduated from the faculty of medicine, Cairo University. He got a Master degree in pediatrics in 1987 and MD in pediatrics in 1995. Recently he got a Diploma of Public health from Liverpool University. He holds the position of a Pediatric Nephrology consultant in Cairo University Children hospital and currently works as pediatric consultant in a military hospital in Saudi Arabia. He has published 12 papers in reputed journals and holds 12 patents in the field of medical engineering in the Egyptian and US patent offices