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.
Pediatric hemodialysis is a machine that is used to clean the blood outside of the body.
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.
The dialysis machine has special monitors that tell the nurse:
Your child’s dialysis care team may measure:
Other lab tests that we check often are:
Other important things we watch closely:
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.
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.
Call your child’s hemodialysis team if you find any of the problems below with your child’s catheter:
Accidents can happen. We want you to be ready. When you are traveling or at home with your child, you should always have an emergency bag of equipment with you. Your bag should always be ready to use. Below has a list of possible problems and what to do in case they happen.
As a dialysis patient, your child is at risk for infections. In the hospital and at home, cleanliness is a key factor in lowering chances of infection.
You can also help by learning:
Your child may take baths or showers, but you must cover all of the catheter dressing and connections.
Ask your child’s nurse to go over any special instructions with you about bathing. It is important to NOT get the catheter dressing or connections wet.
To cover the catheter dressing and connections:
If the catheter dressing gets wet or loose, the dressing should be changed right away. Call the hemodialysis nurse for a plan to get the dressing changed.
Look at the catheter and dressing many times a day: morning, afternoon, night and when concerned.
Hemodialysis catheter care will be done in the hemodialysis clinic. Care includes:
You should have emergency supplies everywhere your child goes. Supplies you should have:
Ways to keep your child’s catheter safe:
One of the jobs of normal kidneys is to remove extra fluid from the body. When the kidneys fail, dialysis can help remove some of the fluid. Kidney failure patients need to eat a low-salt diet and drink less fluid because their kidneys have trouble removing salt and fluid.
Anything you drink is a fluid. This includes water, juice, soda, milk, etc. Some foods count as fluids too, including foods that melt like popsicles or ice cream, and watery foods like watermelon, soups and thin stews.
If your child comes to dialysis with too much fluid, the child may feel bad during the dialysis treatment. They may:
Over time, too much fluid can harm your child’s body. Too much fluid can cause:
Signs and symptoms of having too much fluid in your child’s body:
The amount of fluid depends on how much pee your child makes. Talk to your hemodialysis care team about how much salt and fluid your child can have. Measuring fluids for a while will help your child get used to the limit.
Follow these tips for helping your child when they are thirsty:
Measure and record the amount of salt and fluid your child eats and drinks each day.
Children on hemodialysis should get between 2,000 to 3,000 milligrams (mg) of sodium per day.
Our body needs minerals to be healthy. When the kidneys fail, some minerals build up in the blood. Your child should eat less:
Six tips for lowering sodium:
The food label will help you know how much sodium food contains. The food label is also called Nutrition Facts.
Look at the serving size
Look at the milligrams (mg) of sodium
You may see words on the label that can help you choose lower-sodium foods. Always read the Nutrition Facts to see exactly how much sodium is in the food.
Some fresh foods do not have a food label. They are usually low in sodium.
Phosphorus is found in your bones. Having high phosphorus in your blood will pull calcium out of your bones, making them weak and break easily. The calcium then deposits in the heart, blood vessels and lungs, causing them to harden. Children on hemodialysis should eat less phosphorus.
Try to eat less of these foods:
Potassium is found naturally in most foods. Foods with the most potassium are fruits, vegetables, meats and milk. We measure the potassium we eat in milligrams (mg). Try to eat foods with less than 200 mg of potassium per serving.