As Joe Cosgrove has already pointed out in previous articles, having kidney disease means that your kidneys are not properly working and are not able to filter blood anymore like they should. When this condition gets worst it is known as end-stage renal disease or ESRD and needs to be treated with dialysis.
Most people think that ESRD only affects adults since their bodies are more deteriorated. However, ESRD also affects children. At least 1,462 children in the United States need to start dialysis treatment every year. Most of these children have congenital disorders (33%), have damaged kidneys due to glomerular disease (24,6%), or need to go on dialysis because they have glomerulonephritis (12,9%).
When we talk about adults, the most common causes of kidney failure are related to high blood pressure or diabetes. Nevertheless, when we talk about children, kidney disease is rarely related to those two conditions and it is often caused as a side effect of other treatments or because they have a hereditary condition that may affect their urinary tract.
Treating Children with ESRD in the United States
Every year over 10,000 children is treated for ESRD in the United States. Most of these children use hemodialysis as it is less invasive and easier to adapt to their bodies. This is how, every year 56 percent of these children are treated with hemodialysis and the rest just go under peritoneal dialysis, have kidney transplants or take alternative treatments.
At least 1,300 children are listed for kidney transplant every year. Over the past 20 years, this number seems to have grown dramatically since kidney diseases have become more popular among the U.S. population.
This is how treatments and medical procedures for children have also evolved. Technology has done major improvements and filtering membranes and catheters are now meant to be used in children, so their size is smaller, sometimes they are more resistant and flexible.
At first, there were many side effects related to hemodialysis in children. However, this seems to have been controlled over the past two decades. Now the morbidity rates during dialysis have considerably decreased and it is less common to experience seizures as a side effect during the treatment. The already mentioned medical advances have made it easier for children to deal with such an invasive procedure, so hypotensive episodes are quite uncommon nowadays.
A sensitive treatment
Two decades ago it was common for a dialysis patient to say that it was feeling pain or discomfort during the treatment. Keeping in mind that children’s bodies are more sensitive and fragile, dialysis procedures are less painful and discomforting today. The catheters used during the entire dialysis process are internal, making it impossible for children to remove it without helps. Besides, anesthetic creams are used to puncture the patient.
More sensitive and less invasive technologies have also been developed in order to reduce dramatic effects such as morbidity. These technologies can also reduce healthcare costs, making it simpler for the health care providers too.
Synthetic materials used in children are biocompatible and have a smaller size. This way, tubing and other processes related to pediatric dialysis are easier on the infant’s body. Diameter and length of tubes have been reduced so they can fit the patient’s veins. This way, the volume of filtered blood is going to be adequate both for having a successful a treatment and taking care of the child’s needs.
Machines used in pediatric dialysis are also special ones, so blood pumping is normal compared to the one that happens during the treatment adults get. Most dialysis machines used with children are designed to meet their needs and be used with pediatric patients.
The speed used when the blood is pumped in children is slower than in adults and needs to be kept that way since the capacity of patients to output blood is different and veins could be cloaked. For this reason, children need to be monitored during the entire dialysis session. Machines are always designed in a way that it is easier for healthcare providers to be in control of the dialysis process during the entire time.
Related: Is dialysis always recommendable?
Since children with ESRD will need to be exposed to dialysis for a long period, hemodialysis needs to be seen as a whole and not as a mere step of kidney disease therapy. Dialysis in children should be seen as a temporary thing. This happens because if the patient is feeling better then it will stop the treatment and if things complicate and the kidneys completely fail, then the pediatric patient will need to get a kidney transplant.
When patients have the chance to heal, then hemodialysis enables the chances for patients to improve their condition, while they can keep having a normal life. This treatment can often affect children’s physiologically when it is done in the long term, so it is recommended to give some kind of support to children while they are going through dialysis treatment.