Format

Send to

Choose Destination
Pediatr Nephrol. 2009 Aug;24(8):1587-91. doi: 10.1007/s00467-009-1151-8. Epub 2009 Mar 18.

The value of sequential dialysis, mannitol and midodrine in managing children prone to dialysis failure.

Author information

1
Department of Nephro-urology, Great Ormond Street Hospital for Children, London, UK.

Abstract

The uremic state impairs compensatory responses to ultrafiltration (UF). Intradialytic symptoms and hypotension can result and lead to premature discontinuation of treatment and sub-optimal dialysis. We report the benefits of mannitol, sequential dialysis and midodrine in reducing dialysis failures in those children prone to intradialytic hypotension. Prophylactic mannitol halved the odds of intradialytic symptoms and hypotension and increased UF volumes. Sequential dialysis halved the odds of symptoms but hypotension persisted. In one patient with refractory hypotension, only intradialytic midodrine consistently maintained acceptable intradialytic blood pressures, reduced intradialytic symptoms and increased the UF potential.

PMID:
19294425
DOI:
10.1007/s00467-009-1151-8
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center