A SURVEY ON EXTRACORPOREAL BLOOD DIALYSIS IN CHILDHOOD

Background. - Several methods of dialysis are currently available. The choice of whether to use one of them is determined by multiple factor s that are analyzed in this study. Patients and methods. - One hundred and twenty-six children (mean age: 48 +/- 6 months) were treated in 2 9 French intensive care units and/or departments of nephrology during 1991. The underlying diseases were: hemolytic-uremic syndrome (HUS) in 28% of patients, other renal diseases in 6%, metabolic diseases in 8% , septic shock in 8%, cardiogenic shock in 9%, hypovolemic shock in 10 %, multiple organ failure in 7%, acute liver diseases in 9% and other diseases in 15%. Results. - Peritoneal dialysis (PD) was the favorite method in patients less than 10 years: intermittent hemodialysis (IHD) , continuous hemofiltration and hemodiafiltration (HF, HDF) were prefe rentially used above this age. PD was used in 85% of HUS, 58% of shock s and 50% of metabolic diseases. Sixty percent of acute renal diseases other than HUS were treated by MD. HF and HDF were used in 66% of acu te liver diseases and 42% of shocks. Overall mortality was 40% but no death could be directly ascribed to the different methods of dialysis. Conclusion. - The choice of method depends on the type of underlying disease, age of the patient but also the equipment of centers. Progres s in evaluating indications and results of the different methods of di alysis are necessary.