Dialysis on children

Kidney failure is a condition that not only affects adults but children, teenagers and babies as well. Since they are so young to suffer the struggles dialysis have, they are in most of the cases candidates to get a kidney transplant. Nevertheless, the decision of a kidney transplant is made only when they kidneys fail completely. Until that moment, dialysis is the treatment option.

Fusco Foundation Donation_Dialysis on children_joe cosgrove

Image courtesy of Julie Dennehy at Flickr.com

The challenges of kidney failure for children include physical effects from the loss of kidney function and emotional effects due to their illness. Physical effects of kidney failure can include

  • extreme fatigue
  • weak bones
  • nerve damage
  • sleep problems
  • growth failure

There are two dialysis options for children:

Peritoneal Dialysis is usually the treatment of choice for children. It is gentle and can be done overnight, using the cycler machine (APD). This dialysis is done every day and while children are not doing the dialysis, they can play, go to school, spend time with their friends. There is only one restriction for them, swimming. But, food does not have any restrictions for them: It means, they can enjoy of regular activities children do.

This dialysis will eliminate the most common symptoms of kidney disease such as feeling struggle and tired to do lots of fun activities in the day. The machine cycler or APD (Automated Peritoneal Dialysis) is used while children sleep. The fluid go in and out around 5 or 6 times. Hence, the machine is sit next to their bed at night. Usually, doctors give them a medicine for them to sleep.

A catheter (tube) is required for the dialysis. The catheter is put into the tummy in a special space called peritoneum. Catheters always have a little dressing to keep them clean and stays in place every day. Once the dialysis starts, the catheter is attached to a special bag of dialysis and a drain bag. So, the old fluid come in the drain bag and the new fluid is put in. After new fluids are put in, all the bags are disconnected. It takes around half an hour to complete the whole process so children will not feel they cannot do what other children do.

The second dialysis option for children is Haemodialysis.

Dialysis Machine_Dialysis on children_joe cosgrove

Image courtesy of Amber Case at Flickr.com

Haemodialysis is used less often for children, but it is an effective treatment. Usually it is centre based rather than home. Contrary of the Peritoneal Dialysis that is done at home, Haemodialysis is done at the hospital although older kids can go on home haemodialysis. This dialysis must be done three times a week during the whole morning or the afternoon. Nevertheless, this dialysis does not affect children’s activities. They can play, run, got to school. And, when they are on dialysis, they can read, play with toys, watch TV or movies, do school work or listen to music. In this dialysis, the nurses put a special needle in the dialysis access, usually the arm, using a special cream eliminating any hurting sensation. Then, the needle come out after the dialysis finishes.

However, this dialysis does requires parents to be more attentive and careful with their children’s diet. For instance, protein is very important. It is also recommended to limit sugary foods, fizzy soft drinks, food that are high in bad fats. Also, increasing the fruit, vegetables food intake will make kidneys effort less. Talking about fluids, the right amount of it is prescribed by the kidney specialist since it depends on the kidneys failure.

However parents or guardians are the most important members of a child’s team, children need a more complete team of  skilled professionals who can make things easier during the process: Those professionals are the following:

  • pediatrician
  • nephrologist
  • dialysis nurse
  • transplant coordinator
  • transplant surgeon
  • social worker
  • mental health professional
  • dietitian

Pediatrician

A pediatrician is the doctor who treats children and is likely to be the first to recognize a kidney problem—either during a routine physical exam or during a sick visit.

Nephrologist

A neurologist or pediatric neurologist if possible, is a doctor who treats kidney diseases and kidney failure.

Dialysis Nurse

If the child needs dialysis, a nurse with special training will make sure all procedures are followed carefully.

Transplant Coordinator

When preparing for a transplant, children and their families work with a coordinator at a transplant center, who serves as their main contact.

Transplant Surgeon

The transplant surgeon performs the kidney transplant and monitors a child’s health before the surgery and after the surgery.

Social Worker

Every dialysis clinic and transplant center has a social worker who can help families locate services such as transportation and family counseling.

Mental Health Professional

A mental health professional, such as a psychologist, can help children with CKD find useful ways to deal with the emotional turmoil caused by having a chronic illness.

Dietitian

Proper nutrition is extremely important for children with CKD. Every dialysis clinic has a dietitian to help people understand how the food they eat affects their health.

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