Recent developments in the management of infants with end-stage renal disease

Honda, Masashi; Shishido, Seiichirou

doi:10.1007/bf02480617

Cited by 4 publications

(10 citation statements)

References 40 publications

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“…IVC and iliac vein anomalies in pediatric recipients can be hazardous to renal transplantation, and may necessitate modifications to the standard surgical procedure [1,2,3,4,5,6,7]. Nevertheless, successful renal transplantation in recipients with thrombosis or occlusion of the IVC has been reported [2,4,5,6,7].…”

Section: Discussionmentioning

confidence: 98%

“…Nevertheless, successful renal transplantation in recipients with thrombosis or occlusion of the IVC has been reported [2,4,5,6,7]. The operation is complicated by the need to use the native renal vein, portal vein, or collateral vessels for renovenous anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic IVC abnormalities in pediatric renal transplant recipients have been reported [7]. Detailed vascular anatomical screening by noninvasive procedures is recommended for patients with chronic renal failure before orthotopic renal transplantation [5,7]. The purpose of the present study was to assess the accuracy of magnetic resonance venography (MRV) of the IVC and iliac vein in children being evaluated for orthotopic renal transplantation.…”

Section: Introductionmentioning

confidence: 98%

“…However, with existing renal insufficiency and the small body size of children, invasive procedures have a high potential risk. Asymptomatic IVC abnormalities in pediatric renal transplant recipients have been reported [7]. Detailed vascular anatomical screening by noninvasive procedures is recommended for patients with chronic renal failure before orthotopic renal transplantation [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Rarely, chronic renal failure is associated with vascular anomalies that can change the technical procedures required during renal transplantation and affect patient survival [1,2,3,4,5,6,7]. Angiography has long been considered the gold standard for assessing the patency of the inferior vena cava (IVC) and the iliac vein.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the inferior vena cava in potential pediatric renal transplant recipients

et al. 2004

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Vascular anomalies due to occlusion or thrombosis of the inferior vena cava (IVC) may be hazardous to renal transplantation, and preoperative vascular evaluation is important for safe and successful surgery. The purpose of this study was to assess the utility and accuracy of two-dimensional time-of-flight (2D-TOF) magnetic resonance venography (MRV) as an alternative to conventional angiography for evaluating the IVC and iliac vein in potential pediatric renal transplant recipients. Four children with chronic renal failure were evaluated with 2D-TOF MRV by superior presaturation pulse and target maximum intensity projection. The whole MRV examination and filming required less than 30 min. All four patients had a normal IVC and iliac vein. Two of the patients underwent renal transplantation, and the MRV findings were in total agreement with the final anatomy revealed intraoperatively. MRV is accurate for evaluating the condition of the IVC and iliac vein. It is a reliable, noninvasive and rapid technique that can be considered as an alternative to invasive angiography for evaluation of children scheduled for transplantation. We recommend the use of this noninvasive procedure to ascertain the patency of the IVC in all infants and children with a history of indwelling catheters in the IVC or those with a propensity to thrombosis, i.e., all recipients with nephrotic syndrome. The insertion of catheters in the femoral vein in children who may become candidates for renal transplantation should be discouraged.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the inferior vena cava in potential pediatric renal transplant recipients

et al. 2004

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Head circumference and development in young children after renal transplantation

Motoyama

Kawamura

Aikawa

et al. 2009

Pediatrics International

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Suitable Dialytic Indicators for Pediatric Peritoneal Dialysis Patients: The Alternative to Creatinine Clearance

et al. 2003

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← Objective Owing to the discord between body weight and body surface area (BSA), creatinine clearance (CCr) is predisposed to be small in pediatric patients on peritoneal dialysis (PD). Alternatively, Kt/V creatinine (Kt/V creat), which is normalized to total body water (TBW) rather than BSA, could be a better dialytic indicator. In this study, the efficiency of dialysis and the nutritional status of pediatric patients on chronic PD were examined, and the utility of dialytic indicators was evaluated. ← Patients and Methods 49 patients under 20 years old, in stable condition, and on PD were analyzed. Weekly total Kt/V of urea (Kt/V urea), CCr, Kt/V creat, and normalized protein equivalent of nitrogen appearance (nPNA) were measured for all patients and for patients under 6 years old. The target value was 2.0/week for Kt/V urea and 60 L/week/1.73 m2 for CCr, as recommended by the Kidney Disease Outcomes Quality Initiative guidelines. The target value for Kt/V creat was set as 1.52/week, using a male model with a height of 170 cm and a body weight of 65 kg. ← Results The mean values of delivered Kt/V urea, CCr, Kt/V creat, and nPNA (and proportion of patients that achieved each target value) for all patients were 2.25 ± 0.57/week (67.4%), 53.8 ± 19.3 L/week/1.73 2m (26.5%), 1.83 ± 0.73/week (65.3%), and 1.11 ± 0.42 g/day, respectively. The values for patients under 6 years old were 2.38± 0.26/week (90.0%), 45.9 ± 12.8 L/week/1.73 2m (10.0%), 1.94 ± 0.51/week (90.0%), and 1.52 ± 0.67 g/day, respectively. Stepwise multiple regression analyses revealed that the relationship between CCr and Kt/V urea was affected by the patient's age. ← Conclusions Our pediatric patients achieved the recommended target value of Kt/V urea. At the same time, the nPNA results reflected the patient's status well. However, CCr appeared to be inappropriate as an indicator for patients under 6 years old. Kt/V creat is suggested to be a better dialytic indicator for these patients.

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Recent developments in the management of infants with end-stage renal disease

Cited by 4 publications

References 40 publications

Evaluation of the inferior vena cava in potential pediatric renal transplant recipients

Evaluation of the inferior vena cava in potential pediatric renal transplant recipients

Head circumference and development in young children after renal transplantation

Suitable Dialytic Indicators for Pediatric Peritoneal Dialysis Patients: The Alternative to Creatinine Clearance

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