PMID- 26386590
OWN - NLM
STAT- MEDLINE
DCOM- 20160829
LR  - 20181113
IS  - 1432-198X (Electronic)
IS  - 0931-041X (Linking)
VI  - 31
IP  - 1
DP  - 2016 Jan
TI  - Hemodialysis in children with ventriculoperitoneal shunts: prevalence, management 
      and outcomes.
PG  - 137-43
LID - 10.1007/s00467-015-3204-5 [doi]
AB  - BACKGROUND: Hemodialysis (HD) in children with a concomitant ventriculoperitoneal 
      shunt (VPS) is rare. Registry data suggest that peritoneal dialysis with a VPS is 
      safe, but little is known about HD in the presence of a VPS. METHODS: We 
      performed a 10-year survey to determine the prevalence of a VPS, complications 
      and outcome in children with a VPS on HD in 15 dialysis units from the 13 
      countries participating in the European Pediatric Dialysis Working Group. 
      RESULTS: Eleven cases of HD with a VPS were reported (prevalence 1.33 %; 328 
      patient-months) and compared with prospective Registry data. The median age at 
      start of dialysis was 9.6 [inter-quartile range (IQR) 1.0-15.0] years and median 
      HD vintage was 2.4 (IQR 1.7-3.0) years. Dialysis was performed through a central 
      venous line (CVL) and through an arteriovenous fistula in six and five children, 
      respectively. Three CVL infections occurred in two children, but these children 
      did not develop VPS infections or meningitis. Symptoms of hemodynamic instability 
      were reported in six (55 %) children at least once per week, with hypotension or 
      hypertension occurring in four of these children and nausea, vomiting and 
      headaches occurring in two; four other children reported less frequent symptoms. 
      Seizures on dialysis occurred in two children, at a frequency of less than once 
      per month, with one child also experiencing visual disturbances. During follow-up 
      (median 4.0; IQR 0.38-7.63 years), three children remained on HD and eight had a 
      functioning transplant. No patients were switched to PD. CONCLUSIONS: 
      Hemodialysis in children with a VPS is safe, but associated with frequent 
      symptoms of hemodynamic instability. No episodes of VPS infection or meningitis 
      were seen among the children in the survey, not even in those with CVL sepsis.
FAU - Wright, Elizabeth
AU  - Wright E
AD  - Nephro-Urology Unit, Great Ormond Street Hospital for Children, NHS Foundation 
      Trust, London, WC1N 3JH, UK.
FAU - Fischbach, Michel
AU  - Fischbach M
AD  - Hopital de Hautepierre, Strasbourg, France.
FAU - Zaloszyc, Ariane
AU  - Zaloszyc A
AD  - Hopital de Hautepierre, Strasbourg, France.
FAU - Paglialonga, Fabio
AU  - Paglialonga F
AD  - Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy.
FAU - Aufricht, Christoph
AU  - Aufricht C
AD  - University Hospital of Vienna, Vienna, Austria.
FAU - Dufek, Stephanie
AU  - Dufek S
AD  - Nephro-Urology Unit, Great Ormond Street Hospital for Children, NHS Foundation 
      Trust, London, WC1N 3JH, UK.
FAU - Bakkaloglu, Sevcan
AU  - Bakkaloglu S
AD  - Ankara University Hospital, Ankara, Turkey.
FAU - Klaus, Gunter
AU  - Klaus G
AD  - KfH Pediatric Kidney Center, Marburg, Germany.
FAU - Zurowska, Aleksandra
AU  - Zurowska A
AD  - Gdansk University Medical School, Gdansk, Poland.
FAU - Ekim, Mesiha
AU  - Ekim M
AD  - Gazi University Hospital, Ankara, Turkey.
FAU - Ariceta, Gema
AU  - Ariceta G
AD  - University Hospital Vall d'Hebron, Barcelona, Spain.
FAU - Holtta, Tuula
AU  - Holtta T
AD  - University of Helsinki, Helsinki, Finland.
FAU - Jankauskiene, Augustina
AU  - Jankauskiene A
AD  - Vilnius University, Vilnius, Lithuania.
FAU - Schmitt, Claus Peter
AU  - Schmitt CP
AD  - Center for Pediatric & Adolescent Medicine, Heidelberg, Germany.
FAU - Stefanidis, Constantinos J
AU  - Stefanidis CJ
AD  - "A & P Kyriakou", Children's Hospital, Athens, Greece.
FAU - Walle, Johan Vande
AU  - Walle JV
AD  - Universitair ziekenhuis Gent, Ghent, Belgium.
FAU - Vondrak, Karel
AU  - Vondrak K
AD  - University Hospital Motol, Prague, Czech Republic.
FAU - Edefonti, Alberto
AU  - Edefonti A
AD  - Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy.
FAU - Shroff, Rukshana
AU  - Shroff R
AD  - Nephro-Urology Unit, Great Ormond Street Hospital for Children, NHS Foundation 
      Trust, London, WC1N 3JH, UK. Rukshana.Shroff@gosh.nhs.uk.
CN  - European Paediatric Dialysis Working Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20150919
PL  - Germany
TA  - Pediatr Nephrol
JT  - Pediatric nephrology (Berlin, Germany)
JID - 8708728
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Arteriovenous Shunt, Surgical/*adverse effects
MH  - Catheter-Related Infections/diagnosis/microbiology
MH  - Catheterization, Central Venous/*adverse effects/instrumentation
MH  - Catheters, Indwelling/adverse effects
MH  - Central Venous Catheters/adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Europe
MH  - Female
MH  - Health Care Surveys
MH  - Humans
MH  - Hypertension/diagnosis/etiology
MH  - Hypotension/diagnosis/etiology
MH  - Infant
MH  - Kidney Transplantation
MH  - Male
MH  - Renal Dialysis/*adverse effects
MH  - Renal Insufficiency, Chronic/diagnosis/*therapy
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Seizures/diagnosis/etiology
MH  - Surveys and Questionnaires
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventriculoperitoneal Shunt/*adverse effects/instrumentation
OTO - NOTNLM
OT  - Central venous line
OT  - Children
OT  - Hemodialysis
OT  - Seizures
OT  - Ventriculoperitoneal shunt
EDAT- 2015/09/21 06:00
MHDA- 2016/08/30 06:00
CRDT- 2015/09/21 06:00
PHST- 2015/04/23 00:00 [received]
PHST- 2015/08/28 00:00 [accepted]
PHST- 2015/08/13 00:00 [revised]
PHST- 2015/09/21 06:00 [entrez]
PHST- 2015/09/21 06:00 [pubmed]
PHST- 2016/08/30 06:00 [medline]
AID - 10.1007/s00467-015-3204-5 [pii]
AID - 10.1007/s00467-015-3204-5 [doi]
PST - ppublish
SO  - Pediatr Nephrol. 2016 Jan;31(1):137-43. doi: 10.1007/s00467-015-3204-5. Epub 2015 
      Sep 19.