Pediatric Hemodialysis

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Summary

Dialysis is used when the kidneys stop working. Kidney failure may be temporary or last forever. Kidney failure is also known as end-stage renal disease, or ESRD for short. ESRD is diagnosed when there is permanent loss of 90% of total kidney function.

What is pediatric hemodialysis?

Pediatric hemodialysis is a machine that is used to clean the blood outside of the body.

How does pediatric hemodialysis work?

  1. A dialysis machine uses a pump to remove blood from your child’s vascular access (central line, graft or fistula). 
  2. As the blood goes through the tubing outside the body, it is cleaned by a fluid called dialysate (di-al-y-sate). The dialysate fluid removes the waste and fluid from the blood. Your child’s doctor orders the dialysate based on your child’s needs. 
  3. Once the blood is cleaned, the clean blood returns back to your child through their vascular access.

Each hemodialysis treatment lasts about four hours. They are done three or more times a week. The doctor will give you a prescription that tells you how much treatment your child needs to keep them healthy.

How much blood is outside my child’s body during hemodialysis? 

The machine type is based on your child’s size. For older children, no more than 2 cups (1 pint or 16 ounces) of blood are outside your child’s body. For smaller children, the amount of blood outside the body is even less.

How does the pediatric hemodialysis machine help keep my child safe?

The dialysis machine has special monitors that tell the nurse: 

  • Your child’s blood pressure during dialysis 
  • How fast the blood moves through the machine 
    • Your child’s doctor orders the flow rate that is best for your child 
  • If there are air bubbles 
    • It is important to keep air out of your child’s blood

How do we know that the pediatric hemodialysis is working?

The dialysis care team tests your child’s blood levels often. The blood test results show how dialysis is removing the waste and fluids. This tells us if your child is getting the right amount of dialysis. Blood tests may be drawn each week, each month and each year depending on your child’s needs.

What blood test are checked before/after pediatric hemodialysis?

Your child’s dialysis care team may measure: 

  • Urea reduction ratio (URR) - URR should be at least 65% 
  • Kt/V (kay-tee-over-vee) - Kt/V should be at least 1.2 

Other lab tests that we check often are: 

  • Blood urea nitrogen (BUN) and creatinine – To measure the amount of waste 
  • Sodium (Na) and potassium (K) – To measure chemical amounts in the body 
  • Hemoglobin and hematocrit (H&H) – To measure red blood cell counts 

Other important things we watch closely: 

  • Weight and blood pressure before and after dialysis

Hemodialysis FAQs

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