Hemodialysis in Adolescents

  • Erica WinnickiEmail author
  • Paul Brakeman
  • Marsha Lee
  • Stephanie Nguyen


Hemodialysis is the most common initial treatment for end-stage renal disease in adolescents. The goal of this chapter is to review important aspects of hemodialysis as a treatment for end-stage renal disease in adolescents. Specifically, considerations regarding vascular access, the hemodialysis prescription, potential complications, and patient outcomes are reviewed.


Hemodialysis Central venous catheter Arteriovenous fistula Adequacy Complications 


  1. 1.
    Saran R, Li Y, Robinson B, Abbott KC, Agodoa LY, Ayanian J, et al. US renal data system 2015 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2016;67(3 Suppl 1):Svii. S1-305PubMedGoogle Scholar
  2. 2.
    Amaral S, Sayed BA, Kutner N, Patzer RE. Preemptive kidney transplantation is associated with survival benefits among pediatric patients with end-stage renal disease. Kidney Int. 2016;90(5):1100–8.CrossRefGoogle Scholar
  3. 3.
    Moist LM, Port FK, Orzol SM, Young EW, Ostbye T, Wolfe RA, et al. Predictors of loss of residual renal function among new dialysis patients. J Am Soc Nephrol. 2000;11(3):556–64.PubMedGoogle Scholar
  4. 4.
    Warady BA, Neu AM, Schaefer F. Optimal care of the infant, child, and adolescent on dialysis: 2014 update. Am J Kidney Dis. 2014;64(1):128–42.CrossRefGoogle Scholar
  5. 5.
    NKF. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884–930.CrossRefGoogle Scholar
  6. 6.
    Cooper BA, Branley P, Bulfone L, Collins JF, Craig JC, Fraenkel MB, et al. A randomized, controlled trial of early versus late initiation of dialysis. N Engl J Med. 2010;363(7):609–19.CrossRefGoogle Scholar
  7. 7.
    Beddhu S, Samore MH, Roberts MS, Stoddard GJ, Pappas LM, Cheung AK. Creatinine production, nutrition, and glomerular filtration rate estimation. J Am Soc Nephrol. 2003;14(4):1000–5.CrossRefGoogle Scholar
  8. 8.
    Chesnaye N, Bonthuis M, Schaefer F, Groothoff JW, Verrina E, Heaf JG, et al. Demographics of paediatric renal replacement therapy in Europe: a report of the ESPN/ERA–EDTA registry. Pediatr Nephrol. 2014;29(12):2403–10.CrossRefGoogle Scholar
  9. 9.
    Atkinson MA, Oberai PC, Neu AM, Fivush BA, Parekh RS. Predictors and consequences of higher estimated glomerular filtration rate at dialysis initiation. Pediatr Nephrol. 2010;25(6):1153–61.CrossRefGoogle Scholar
  10. 10.
    Rehman R, Schmidt RJ, Moss AH. Ethical and legal obligation to avoid long-term tunneled catheter access. Clin J Am Soc Nephrol. 2009;4(2):456–60.CrossRefGoogle Scholar
  11. 11.
    Stevenson KB, Hannah EL, Lowder CA, Adcox MJ, Davidson RL, Mallea MC, et al. Epidemiology of hemodialysis vascular access infections from longitudinal infection surveillance data: predicting the impact of NKF-DOQI clinical practice guidelines for vascular access. Am J Kidney Dis. 2002;39(3):549–55.CrossRefGoogle Scholar
  12. 12.
    Zaritsky JJ, Salusky IB, Gales B, Ramos G, Atkinson J, Allsteadt A, et al. Vascular access complications in long-term pediatric hemodialysis patients. Pediatr Nephrol. 2008;23(11):2061–5.CrossRefGoogle Scholar
  13. 13.
    NKF. KDOQI clinical practice guidelines and clinical practice recommendations for 2006 updates: hemodialysis adequacy, peritoneal dialysis adequacy, and vascular access. Am J Kidney Dis. 2006;48(Suppl 1):S1–S322.Google Scholar
  14. 14.
    NAPTRCS. North American pediatric renal trials and collaborative studies annual dialysis report. 2011.Google Scholar
  15. 15.
    Chand DH, Valentini RP, Kamil ES. Hemodialysis vascular access options in pediatrics: considerations for patients and practitioners. Pediatr Nephrol. 2009;24(6):1121–8.CrossRefGoogle Scholar
  16. 16.
    Control CfD. Core interventions.Google Scholar
  17. 17.
    Zhao Y, Li Z, Zhang L, Yang J, Yang Y, Tang Y, et al. Citrate versus heparin lock for hemodialysis catheters: a systematic review and meta-analysis of randomized controlled trials. Am J Kidney Dis. 2014;63(3):479–90.CrossRefGoogle Scholar
  18. 18.
    Ramage IJ, Bailie A, Tyerman KS, McColl JH, Pollard SG, Fitzpatrick MM. Vascular access survival in children and young adults receiving long-term hemodialysis. Am J Kidney Dis. 2005;45(4):708–14.CrossRefGoogle Scholar
  19. 19.
    Ramanathan V, Darouiche RO. Prevention and management of hemodialysis catheter infections. Expert Rev Anti-Infect Ther. 2012;10(12):1447–55.CrossRefGoogle Scholar
  20. 20.
    Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45.CrossRefGoogle Scholar
  21. 21.
    Duronville JV, Diamantidis CJ. Medical safety in the care of the person with end-stage kidney disease. Semin Dial. 2018;31(2):140–8.CrossRefGoogle Scholar
  22. 22.
    Casey JR, Hanson CS, Winkelmayer WC, Craig JC, Palmer S, Strippoli GF, et al. Patients’ perspectives on hemodialysis vascular access: a systematic review of qualitative studies. Am J Kidney Dis. 2014;64(6):937–53.CrossRefGoogle Scholar
  23. 23.
    Eloot S, Van Biesen W, Glorieux G, Neirynck N, Dhondt A, Vanholder R. Does the adequacy parameter Kt/V(urea) reflect uremic toxin concentrations in hemodialysis patients? PLoS One. 2013;8(11):e76838.CrossRefGoogle Scholar
  24. 24.
    Lisowska-Myjak B. Uremic toxins and their effects on multiple organ systems. Nephron Clin Pract. 2014;128(3–4):303–11.CrossRefGoogle Scholar
  25. 25.
    Gotch FA, Sargent JA. A mechanistic analysis of the National Cooperative Dialysis Study (NCDS). Kidney Int. 1985;28(3):526–34.CrossRefGoogle Scholar
  26. 26.
    Daugirdas JT. Kt/V (and especially its modifications) remains a useful measure of hemodialysis dose. Kidney Int. 2015;88(3):466–73.CrossRefGoogle Scholar
  27. 27.
    Group FHNT, Chertow GM, Levin NW, Beck GJ, Depner TA, Eggers PW, et al. In-center hemodialysis six times per week versus three times per week. N Engl J Med. 2010;363(24):2287–300.CrossRefGoogle Scholar
  28. 28.
    Rocco MV, Lockridge RS Jr, Beck GJ, Eggers PW, Gassman JJ, Greene T, et al. The effects of frequent nocturnal home hemodialysis: the frequent hemodialysis network nocturnal trial. Kidney Int. 2011;80(10):1080–91.CrossRefGoogle Scholar
  29. 29.
    Fine RN. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: a historical perspective. Pediatr Nephrol. 2010;25(4):725–32.CrossRefGoogle Scholar
  30. 30.
    Hodson EM, Willis NS, Craig JC. Growth hormone for children with chronic kidney disease. Cochrane Database Syst Rev. 2012;2Google Scholar
  31. 31.
    Ingulli EG, Mak RH. Growth in children with chronic kidney disease: role of nutrition, growth hormone, dialysis, and steroids. Curr Opin Pediatr. 2014;26(2):187–92.CrossRefGoogle Scholar
  32. 32.
    Greenbaum LA, Warady BA, Furth SL. Current advances in chronic kidney disease in children: growth, cardiovascular, and neurocognitive risk factors. Semin Nephrol. 2009;29(4):425–34.CrossRefGoogle Scholar
  33. 33.
    Haffner D, Zivicnjak M. Pubertal development in children with chronic kidney disease. Pediatr Nephrol. 2017;32(6):949–64.CrossRefGoogle Scholar
  34. 34.
    Karunaratne K, Taube D, Khalil N, Perry R, Malhotra PA. Neurological complications of renal dialysis and transplantation. Pract Neurol. 2018;18(2):115–25.CrossRefGoogle Scholar
  35. 35.
    Moledina DG, Perry WF. Pharmacologic treatment of common symptoms in dialysis patients: a narrative review. Semin Dial. 2015;28(4):377–83.CrossRefGoogle Scholar
  36. 36.
    Zepeda-Orozco D, Quigley R. Dialysis disequilibrium syndrome. Pediatr Nephrol. 2012;27(12):2205–11.CrossRefGoogle Scholar
  37. 37.
    Bossola M, Vulpio C, Tazza L. Fatigue in chronic dialysis patients. Semin Dial. 2011;24(5):550–5.CrossRefGoogle Scholar
  38. 38.
    Kosmadakis GC, Bevington A, Smith AC, Clapp EL, Viana JL, Bishop NC, et al. Physical exercise in patients with severe kidney disease. Nephron Clin Pract. 2010;115(1):c7–c16.CrossRefGoogle Scholar
  39. 39.
    Brkovic T, Burilovic E, Puljak L. Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: a systematic review. Patient Prefer Adherence. 2016;10:1131–50.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Pham PC, Khaing K, Sievers TM, Pham PM, Miller JM, Pham SV, et al. 2017 update on pain management in patients with chronic kidney disease. Clin Kidney J. 2017;10(5):688–97.CrossRefGoogle Scholar
  41. 41.
    Ko CW, Chang CS, Lien HC, Wu MJ, Chen GH. Gastric dysrhythmia in uremic patients on maintenance hemodialysis. Scand J Gastroenterol. 1998;33(10):1047–51.CrossRefGoogle Scholar
  42. 42.
    Salles Junior LD, Santos PR, dos Santos AA, de Souza MH. Dyspepsia and gastric emptying in end-stage renal disease patients on hemodialysis. BMC Nephrol. 2013;14:275.CrossRefGoogle Scholar
  43. 43.
    Shirazian S, Radhakrishnan J. Gastrointestinal disorders and renal failure: exploring the connection. Nat Rev Nephrol. 2010;6(8):480–92.CrossRefGoogle Scholar
  44. 44.
    Silang R, Regalado M, Cheng TH, Wesson DE. Prokinetic agents increase plasma albumin in hypoalbuminemic chronic dialysis patients with delayed gastric emptying. Am J Kidney Dis. 2001;37(2):287–93.CrossRefGoogle Scholar
  45. 45.
    Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017;32(2):243–8.CrossRefGoogle Scholar
  46. 46.
    Chesnaye NC, Schaefer F, Groothoff JW, Bonthuis M, Reusz G, Heaf JG, et al. Mortality risk in European children with end-stage renal disease on dialysis. Kidney Int. 2016;89(6):1355–62.CrossRefGoogle Scholar
  47. 47.
    Mitsnefes MM, Laskin BL, Dahhou M, Zhang X, Foster BJ. Mortality risk among children initially treated with dialysis for end-stage kidney disease, 1990–2010. JAMA. 2013;309(18):1921–9.CrossRefGoogle Scholar
  48. 48.
    McDonald SP, Craig JC. Long-term survival of children with end-stage renal disease. N Engl J Med. 2004;350(26):2654–62.CrossRefGoogle Scholar
  49. 49.
    Banerjee D. Sudden cardiac death in haemodialysis: clinical epidemiology and mechanisms. J Electrocardiol. 2016;49(6):843–7.CrossRefGoogle Scholar
  50. 50.
    Krishnasamy R, Badve SV, Hawley CM, McDonald SP, Boudville N, Brown FG, et al. Daily variation in death in patients treated by long-term dialysis: comparison of in-center hemodialysis to peritoneal and home hemodialysis. Am J Kidney Dis. 61(1):96–103.CrossRefGoogle Scholar
  51. 51.
    Foley RN, Gilbertson DT, Murray T, Collins AJ. Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med. 2011;365(12):1099–107.CrossRefGoogle Scholar
  52. 52.
    Springel T, Laskin B, Shults J, Keren R, Furth S. Longer interdialytic interval and cause-specific hospitalization in children receiving chronic dialysis. Nephrol Dial Transplant. 2013;28(10):2628–36.CrossRefGoogle Scholar
  53. 53.
    McCullough PA, Chan CT, Weinhandl ED, Burkart JM, Bakris GL. Intensive hemodialysis, left ventricular hypertrophy, and cardiovascular disease. Am J Kidney Dis. 2016;68(5S1):S5–S14.CrossRefGoogle Scholar
  54. 54.
    Chavers BM, Solid CA, Daniels FX, Chen S-C, Collins AJ, Frankenfield DL, et al. Hypertension in pediatric long-term hemodialysis patients in the United States. Clin J Am Soc Nephrol. 2009;4(8):1363–9.CrossRefGoogle Scholar
  55. 55.
    Glassock RJ, Pecoits-Filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol. 2009;4(Supplement 1):S79–91.CrossRefGoogle Scholar
  56. 56.
    Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904.CrossRefGoogle Scholar
  57. 57.
    Dionne JM. Evidence-based guidelines for the management of hypertension in children with chronic kidney disease. Pediatr Nephrol. 2015;30(11):1919–27.CrossRefGoogle Scholar
  58. 58.
    Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920.CrossRefGoogle Scholar
  59. 59.
    Chaudhuri A, Sutherland SM, Begin B, Salsbery K, McCabe L, Potter D, et al. Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis. Clin J Am Soc Nephrol. 2011;6(4):870–6.CrossRefGoogle Scholar
  60. 60.
    KDOQI W. K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis. 2005;45(4 Suppl 3):S1-153.Google Scholar
  61. 61.
    Agarwal R, Sinha AD. Cardiovascular protection with antihypertensive drugs in dialysis patients. Syst Rev Meta-Anal. 2009;53(5):860–6.Google Scholar
  62. 62.
    Heerspink HJL, Ninomiya T, Zoungas S, de Zeeuw D, Grobbee DE, Jardine MJ, et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet. 2009;373(9668):1009–15.CrossRefGoogle Scholar
  63. 63.
    Efrati S, Zaidenstein R, Dishy V, Beberashvili I, Sharist M, Averbukh Z, et al. ACE inhibitors and survival of hemodialysis patients. Am J Kidney Dis. 2002;40(5):1023–9.CrossRefGoogle Scholar
  64. 64.
    Tai DJ, Lim TW, James MT, Manns BJ, Tonelli M, Hemmelgarn BR, et al. Cardiovascular effects of angiotensin converting enzyme inhibition or angiotensin receptor blockade in hemodialysis: a meta-analysis. Clin J Am Soc Nephrol. 2010;5(4):623–30.CrossRefGoogle Scholar
  65. 65.
    Sorof JM, Brewer ED, Portman RJ. Ambulatory blood pressure monitoring and interdialytic weight gain in children receiving chronic hemodialysis. Am J Kidney Dis. 1999;33(4):667–74.CrossRefGoogle Scholar
  66. 66.
    Candan C, Sever L, Civilibal M, Caliskan S, Arisoy N. Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients. Pediatr Nephrol. 2009;24(3):581–7.CrossRefGoogle Scholar
  67. 67.
    Patel HP, Goldstein SL, Mahan JD, Smith B, Fried CB, Currier H, et al. A standard, noninvasive monitoring of hematocrit algorithm improves blood pressure control in pediatric hemodialysis patients. Clin J Am Soc Nephrol. 2007;2(2):252–7.CrossRefGoogle Scholar
  68. 68.
    Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2006;69(11):1945–53.CrossRefGoogle Scholar
  69. 69.
    Hanudel MR, Salusky IB. Treatment of pediatric chronic kidney disease-mineral and bone disorder. Curr Osteoporos Rep. 2017;15(3):198–206.CrossRefGoogle Scholar
  70. 70.
    Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2017;7:1–59.Google Scholar
  71. 71.
    NKF. K/DOQI clinical practice guidelines for bone metabolism and disease in children with chronic kidney disease. Am J Kidney Dis. 2005;46:S1–S122.Google Scholar
  72. 72.
    NKF. K/DOQI clinical practice guidelines for nutrition in children with chronic kidney disease: 2008 update. Am J Kidney Dis. 2009;53:S1–123.Google Scholar
  73. 73.
    Wesseling-Perry K, Salusky IB. Phosphate binders, vitamin D and calcimimetics in the management of chronic kidney disease–mineral bone disorders (CKD-MBD) in children. Pediatr Nephrol. 2013;28(4):617–25.CrossRefGoogle Scholar
  74. 74.
    Hahn D, Hodson EM, Craig JC. Interventions for metabolic bone disease in children with chronic kidney disease. Cochrane Database Syst Rev 2015;(11): CD008327. DOI: p. 1–92.
  75. 75.
    Gonzalez E, Schomberg J, Amin N, Salusky IB, Zaritsky J. Sevelamer carbonate increases serum bicarbonate in pediatric dialysis patients. Pediatr Nephrol. 2010;25(2):373–5.CrossRefGoogle Scholar
  76. 76.
    Pieper AK, Haffner D, Hoppe B, Dittrich K, Offner G, Bonzel KE, et al. A randomized crossover trial comparing sevelamer with calcium acetate in children with CKD. Am J Kidney Dis. 2006;47(4):625–35.CrossRefGoogle Scholar
  77. 77.
    Fosrenol (lanthanum carbonate) [package insert]. Wayne: Shire US; 2011.Google Scholar
  78. 78.
    Spasovski GB, Sikole A, Gelev S, Masin-Spasovska J, Freemont T, Webster I, et al. Evolution of bone and plasma concentration of lanthanum in dialysis patients before, during 1 year of treatment with lanthanum carbonate and after 2 years of follow-up. Nephrol Dial Transplant. 2006;21(8):2217–24.CrossRefGoogle Scholar
  79. 79.
    Salusky IB, Goodman WG, Sahney S, Gales B, Perilloux A, Wang HJ, et al. Sevelamer controls parathyroid hormone-induced bone disease as efficiently as calcium carbonate without increasing serum calcium levels during therapy with active vitamin D sterols. J Am Soc Nephrol. 2005;16(8):2501–8.CrossRefGoogle Scholar
  80. 80.
    Ballinger AE, Palmer SC, Nistor I, Craig JC, Strippoli GFM. Calcimimetics for secondary hyperparathyroidism in chronic kidney disease patients. Cochrane Database Syst Rev 2014;(12): CD006254. DOI: p. 1–84.
  81. 81.
    Muscheites J, Wigger M, Drueckler E, Fischer DC, Kundt G, Haffner D. Cinacalcet for secondary hyperparathyroidism in children with end-stage renal disease. Pediatr Nephrol. 2008;23(10):1823–9.CrossRefGoogle Scholar
  82. 82.
    Padhi D, Langman CB, Fathallah-Shaykh S, Warady BA, Salusky IB, Lee E, et al. An open-label study to evaluate a single-dose of cinacalcet in pediatric dialysis subjects. Pediatr Nephrol. 2012;27(10):1953–9.CrossRefGoogle Scholar
  83. 83.
    Platt C, Inward C, McGraw M, Dudley J, Tizard J, Burren C, et al. Middle-term use of cinacalcet in paediatric dialysis patients. Pediatr Nephrol. 2010;25(1):143–8.CrossRefGoogle Scholar
  84. 84.
    Silverstein DM, Kher KK, Moudgil A, Khurana M, Wilcox J, Moylan K. Cinacalcet is efficacious in pediatric dialysis patients. Pediatr Nephrol. 2008;23(10):1817–22.CrossRefGoogle Scholar
  85. 85.
    Kim J, Ross JS, Kapczynski A. Pediatric exclusivity and regulatory authority: implications of amgen v hhs. JAMA. 2018;319(1):21–2.CrossRefGoogle Scholar
  86. 86.
    Wong H, Mylrea K, Feber J, Drukker A, Filler G. Prevalence of complications in children with chronic kidney disease according to KDOQI. Kidney Int. 2006;70(3):585–90.CrossRefGoogle Scholar
  87. 87.
    Chavers BM, Roberts TL, Herzog CA, Collins AJ, St Peter WL. Prevalence of anemia in erythropoietin-treated pediatric as compared to adult chronic dialysis patients. Kidney Int. 2004;65(1):266–73.CrossRefGoogle Scholar
  88. 88.
    Donnelly S. Why is erythropoietin made in the kidney? The kidney functions as a critmeter. Am J Kidney Dis. 2001;38(2):415–25.CrossRefGoogle Scholar
  89. 89.
    Atkinson MA, Furth SL. Anemia in children with chronic kidney disease. Nat Rev Nephrol. 2011;7(11):635–41.CrossRefGoogle Scholar
  90. 90.
    Nissenson AR, Strobos J. Iron deficiency in patients with renal failure. Kidney Int Suppl. 1999;69:S18–21.CrossRefGoogle Scholar
  91. 91.
    Warady BA, Ho M. Morbidity and mortality in children with anemia at initiation of dialysis. Pediatr Nephrol. 2003;18(10):1055–62.CrossRefGoogle Scholar
  92. 92.
    Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, et al. The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med. 1998;339(9):584–90.CrossRefGoogle Scholar
  93. 93.
    Parfrey PS, Foley RN, Wittreich BH, Sullivan DJ, Zagari MJ, Frei D. Double-blind comparison of full and partial anemia correction in incident hemodialysis patients without symptomatic heart disease. J Am Soc Nephrol. 2005;16(7):2180–9.CrossRefGoogle Scholar
  94. 94.
    Amaral S, Hwang W, Fivush B, Neu A, Frankenfield D, Furth S. Association of mortality and hospitalization with achievement of adult hemoglobin targets in adolescents maintained on hemodialysis. J Am Soc Nephrol. 2006;17(10):2878–85.CrossRefGoogle Scholar
  95. 95.
    Rheault MN, Molony JT, Nevins T, Herzog CA, Chavers BM. Hemoglobin of 12 g/dl and above is not associated with increased cardiovascular morbidity in children on hemodialysis. Kidney Int. 2017;91(1):177–82.CrossRefGoogle Scholar
  96. 96.
    Gerson A, Hwang W, Fiorenza J, Barth K, Kaskel F, Weiss L, et al. Anemia and health-related quality of life in adolescents with chronic kidney disease. Am J Kidney Dis. 2004;44(6):1017–23.CrossRefGoogle Scholar
  97. 97.
    Van Damme-Lombaerts R, Broyer M, Businger J, Baldauf C, Stocker H. A study of recombinant human erythropoietin in the treatment of anaemia of chronic renal failure in children on haemodialysis. Pediatr Nephrol. 1994;8(3):338–42.CrossRefGoogle Scholar
  98. 98.
    Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int. 2012;2:279–335.Google Scholar
  99. 99.
    Rambod M, Kovesdy CP, Kalantar-Zadeh K. Combined high serum ferritin and low iron saturation in hemodialysis patients: the role of inflammation. Clin J Am Soc Nephrol. 2008;3(6):1691–701.CrossRefGoogle Scholar
  100. 100.
    Albaramki J, Hodson EM, Craig JC, Webster AC. Parenteral versus oral iron therapy for adults and children with chronic kidney disease. Cochrane Database Syst Rev (Online). 2012;1:CD007857.Google Scholar
  101. 101.
    Pandey R, Daloul R, Coyne DW. Iron treatment strategies in dialysis-dependent CKD. Semin Nephrol. 2016;36(2):105–11.CrossRefGoogle Scholar
  102. 102.
    Obrador GT, Macdougall IC. Effect of red cell transfusions on future kidney transplantation. Clin J Am Soc Nephrol. 2013;8(5):852–60.CrossRefGoogle Scholar
  103. 103.
    Warady BA, Arar MY, Lerner G, Nakanishi AM, Stehman-Breen C. Darbepoetin alfa for the treatment of anemia in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2006;21(8):1144–52.CrossRefGoogle Scholar
  104. 104.
    De Palo T, Giordano M, Palumbo F, Bellantuono R, Messina G, Colella V, et al. Clinical experience with darbepoetin alfa (NESP) in children undergoing hemodialysis. Pediatr Nephrol. 2004;19(3):337–40.CrossRefGoogle Scholar
  105. 105.
    Warady BA, Silverstein DM. Management of anemia with erythropoietic-stimulating agents in children with chronic kidney disease. Pediatr Nephrol. 2014;29(9):1493–505.CrossRefGoogle Scholar
  106. 106.
    Chavers BM, Molony JT, Solid CA, Rheault MN, Collins AJ. One-year mortality rates in US children with end-stage renal disease. Am J Nephrol. 2015;41(2):121–8.CrossRefGoogle Scholar
  107. 107.
    Samuel SM, Tonelli MA, Foster BJ, Alexander RT, Nettel-Aguirre A, Soo A, et al. Survival in pediatric dialysis and transplant patients. Clin J Am Soc Nephrol. 2011;6(5):1094–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Erica Winnicki
    • 1
    Email author
  • Paul Brakeman
    • 2
  • Marsha Lee
    • 3
  • Stephanie Nguyen
    • 4
  1. 1.Department of Pediatrics, Division of NephrologyUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of PediatricsUCSF Benioff Children’s Hospital San Francisco, University of California, San FranciscoSan FranciscoUSA
  3. 3.UCSF Benioff Children’s Hospital Pediatric Dialysis Unit, UCSF Benioff Children’s Hospital, Pediatric NephrologySan FranciscoUSA
  4. 4.Department of PediatricsUC Davis Children’s HospitalSacramentoUSA

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