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Haemodiafiltration use in children: data from the Italian Pediatric Dialysis Registry

  • Fabio PaglialongaEmail author
  • Enrico Vidal
  • Carmine Pecoraro
  • Isabella Guzzo
  • Mario Giordano
  • Bruno Gianoglio
  • Ciro Corrado
  • Rosa Roperto
  • Ilse Ratsch
  • Salvatore Luzio
  • Luisa Murer
  • Silvia Consolo
  • Giovanni Pieri
  • Giovanni Montini
  • Alberto Edefonti
  • Enrico Verrina
Original Article
Part of the following topical collections:
  1. What's New in Dialysis

Abstract

Background

High volume haemodiafiltration (HDF) is associated with better survival than conventional haemodialysis (HD) in adults, but data concerning its use in children are lacking. The aim of this study was to assess the prevalence of paediatric HDF use and its associated factors in recent years in Italy.

Methods

We retrospectively reviewed the files of patients from the Italian Pediatric Dialysis Registry’s database who were registered between January 1, 2004 and December 31, 2016 and treated with extracorporeal dialysis for at least 6 months, looking in particular at modality and its associated factors.

Results

One hundred forty-one out of 198 patients were treated exclusively with bicarbonate HD (71.2%), 57 with HDF (28.8%). Patients treated with HDF were younger (median 9.7 vs 13.2 years, p = 0.0008), were less often incident patients (52.6% vs 75.9%, p = 0.0031), had longer duration of the HD cycle (26.9 vs 20.8 months, p = 0.0036) and had a longer time to renal transplantation (32 vs 25 months, p = 0.0029) than those treated with bicarbonate HD only. The percentage of patients treated with HDF increased with dialysis vintage (16.9% at 6 months, 38.1% after more than 2 years of dialysis). The use of HDF was stable over time and was more common in the largest centres.

Conclusions

Over the observation period, HDF use in Italy has been limited to roughly a quarter of patients on extracorporeal dialysis, in particular to those with high dialysis vintage, younger age or a long expected waiting time to renal transplantation.

Keywords

Extracorporeal dialysis Children Paediatric dialysis Haemodiafiltration Haemodialysis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© IPNA 2019

Authors and Affiliations

  • Fabio Paglialonga
    • 1
    Email author
  • Enrico Vidal
    • 2
  • Carmine Pecoraro
    • 3
  • Isabella Guzzo
    • 4
  • Mario Giordano
    • 5
  • Bruno Gianoglio
    • 6
  • Ciro Corrado
    • 7
  • Rosa Roperto
    • 8
  • Ilse Ratsch
    • 9
  • Salvatore Luzio
    • 10
  • Luisa Murer
    • 2
  • Silvia Consolo
    • 1
  • Giovanni Pieri
    • 1
  • Giovanni Montini
    • 1
  • Alberto Edefonti
    • 1
  • Enrico Verrina
    • 10
  1. 1.Pediatric Nephrology, Dialysis and Transplant UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women’s and Children’s HealthUniversity-HospitalPaduaItaly
  3. 3.Nephrology and Dialysis UnitSantobono Children’s HospitalNaplesItaly
  4. 4.Nephrology and Dialysis Unit, Department of Pediatrics“Bambino Gesù” Children’s Hospital-IRCCSRomeItaly
  5. 5.Nephrology Division and Dialysis UnitGiovanni XXIII Children’s HospitalBariItaly
  6. 6.Nephrology Dialysis and Transplantation UnitRegina Margherita University HospitalTurinItaly
  7. 7.Pediatric Nephrology and Dialysis UnitChildren’s Hospital G. Di CristinaPalermoItaly
  8. 8.Nephrology and Dialysis UnitMeyer Children’s HospitalFlorenceItaly
  9. 9.University Department of PediatricsUnited Hospitals of AnconaAnconaItaly
  10. 10.Dialysis Unit, Paediatric Nephrology and Dialysis DepartmentG Gaslini Children HospitalGenoaItaly

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