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Dialyse

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Nierenerkrankungen im Kindes- und Jugendalter

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Zusammenfassung

Die ersten erfolgreichen Dialysen wurden bei Erwachsenen in den 1940er Jahren, bei Kindern in den 1950er Jahren durchgeführt. Der technische Aufwand war enorm und die Realisierbarkeit anfänglich auf wenige Monate beschränkt. Mit modernen Dialyseverfahren sind erfolgreiche Peritonealdialysebehandlungen über mehr als 10 Jahre keine Seltenheit, mit der Hämodialyse wurden Patienten in Einzelfällen über mehr als 40 Jahre behandelt. Dennoch ist in aller Regel angesichts der besseren Langzeitprognose und der höheren Lebensqualität primär eine Nierentransplantation anzustreben. Für die vielen Jahrzehnte Lebenserwartung pädiatrischer Patienten mit CKD5 und angesichts des gravierenden Mangels an Spenderorganen haben jedoch beide Dialyseverfahren einen wesentlichen Stellenwert und erhebliche prognostische Bedeutung. In der Intensivmedizin ist die Akutdialyse in allen Altersklassen unverzichtbar und oft lebensrettend. Bei der Auswahl der Dialyse muss die zu Grunde liegende Erkrankung, die Art der Vergiftung und das Ausmaß der Überwässerung berücksichtigt werden. Wasserlösliche Toxine benötigen grundsätzlich andere Dialyseformen als eiweißgebundene Substanzen und Antikörper.

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Authors and Affiliations

  1. Zentrum für Kinder- und Jugendmedizin Kinderheilkunde I Pädiatrische Nephrologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg

    Prof. Dr. med. Claus Peter Schmitt

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  1. Prof. Dr. med. Claus Peter Schmitt
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  1. Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Köln, Köln

    Jörg Dötsch  & Lutz T. Weber  & 

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Schmitt, C. (2017). Dialyse. In: Dötsch, J., Weber, L. (eds) Nierenerkrankungen im Kindes- und Jugendalter. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48789-1_8

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  • DOI: https://doi.org/10.1007/978-3-662-48789-1_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-48788-4

  • Online ISBN: 978-3-662-48789-1

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