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Original Article

Evaluation of fluid overload markers in pediatric hemodialysis patients

Deniz Karakaya, Tulin Gungor, Evrim Kargin Cakici, Fatma Yazilitas, Evra Celikkaya, Mehmet Bulbul.


Assessment of hydration status in children undergoing hemodialysis (HD) is crucial. This study aimed to identify the techniques that can be utilized to assess fluid overload in children with end-stage renal disease (ESRD) undergoing HD. The study included 9 patients aged >5 years and < 18 years who underwent 27 HD sessions and were followed up for ≥1 month. The median age of the patients was 16 years (IQR: 5-17.8 years) and the female/male ratio was 1.25:1. Symptoms of volume overload were clinically observed based on 5 (18.5%) of the 27 measurements. There was a significant positive linear correlation between fluid overload by weight and pre- and post-HD bioimpedance spectroscopy (BIS) measurements (OH) (r=0.95 [P=0.000]). There was a significant difference in median IVC diameter between pre-HD and after HD (P=0.029). The median pre-HD IVC collapsing index was 13.8% (IRQ: 4%-46%), versus 17.1% (IRQ: 4.5%-45%) after HD; the difference was significant (P=0.000). BIS is the most widely used body composition monitor for estimating fluid status in children undergoing HD. The present study investigated the sensitivity of markers of volume load in children on a routine HD program. The parameters that best indicate volume load are the differences between pre-HD and post-HD BIS measurements, physical examination findings, and heart rate measurements.

Key words: Children, hemodialysis, bioimpedance spectroscopy

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