الفهرس 
HemodialysisOnly 14 pages are availabe for public view
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Abstract
The aim of our work was to assess and follow up dry weight and hydration status in pediatric patients on hemodialysis and its reflection on intradialytic complications.
This prospective follow up clinical study was conducted at the Pediatric Dialysis Unit (PDU), Children’s Hospital, Ain Shams University, Cairo, Egypt from September 2011 till September 2012. The study was conducted on all pediatric patients in our unit on regular hemodialysis fulfilling the inclusion criteria. Those were 40 patients. They were 21 (52.5%) males and 19 (47.5%) females. Their ages ranged from 4 to 25 years with a mean age of 13.85 ± 4.44 years old. Follow up was done on 35 patients.
At the beginning of the study we assessed the patients’ DW by three methods (i) BIS (ii) IVCD (iii) clinical assessment. We changed the patients’ DW according to the BIS recommendations and followed them up clinically for 8 months. During the follow up period we changed the DW of the patients according to our clinical assessment when needed. At the end of the follow up period, another assessment of DW was done via the three methods and another clinical follow up period of 3 months was done to assess the new results.
The study proved that HD sessions caused a significant effect on ECW causing a significant reduction in IVCD, TBW, OH, E/I ratio, systolic and diastolic blood pressure at the beginning and the end of the study. HD sessions had no significant effect on ICW.
Concerning body tissue parameters, LTM and LTI were significantly decreased at the beginning of the study due to the underestimation of our patients’ DW. After adjusting their DW via the BIS recommendations, HD sessions had no significant effect on both. As for the body fat parameters (fat, FTI and ATM) they were not significantly affected by HD sessions at the beginning and the end of the study.
By estimating the concordance between the three methods of DW assessment, the study found that the concordance between clinical recommendations and both BIS and IVCD recommendations increased by the end of our study. Yet the concordance between BIS and IVCD recommendations slightly decreased. This study proves that BIS is slightly better than IVCD in supporting clinical decision.
After adjusting the patients’ DW according to the BIS recommendations, the number of intradialytic hypotensive episodes decreased in the end of the study. Changing the patients’ DW in a gradual manner in the second time (over one month) had a positive impact on all our patients resulting in no cardiac complications.