Blood Volume Monitoring to Assess Dry Weight in Pediatric Chronic Hemodialysis Patients.

OBJECTIVE Volume overload from an incorrect assessment of dry weight leads to cardiovascular diseases in chronic hemodialysis patients. Dry weight assessment in pediatric is difficult for a number of reasons including growth. Blood volume monitoring (BVM) has been proposed as an accurate method of estimating dry weight in adult. However, there is very scant data regarding B VM assessment in pediatric. Therefore, the authors conducted a study to compare dry weight, postdialytic body weight, predialytic blood pressure, intradialytic blood pressure, and intra dialytic symptoms between clinical adjustment and B VM method. MATERIAL AND METHOD In pediatric chronic hemodialysis patient, B VM was performed to guide ultrafiltration to adjust dry weight compared with clinical adjustment. Data including dry weight, postdialytic body weight, predialytic blood pressure, intradialytic hypotension, and intradialytic symptoms were analyzed over each 1-month period of treatment course. RESULTS Ten patients (5 males/5 females, age 16.55 ± 2.49 years) were enrolled. Comparing clinical adjustment to assess dry weight with BVM, there were no differences in dry weight (38.38 ± 7.43 vs. 38.12 ± 7.58 kg) and postdialytic body weight (38.54 ± 7.61 vs. 38.23 ± 7.35) of both methods. Dry weight adjusted by clinical adjustment trends to higher than by BVM (0.14 ± 0.46 vs. -0.26 ± 0.57 kg). There is also no difference between predialytic blood pressure of both methods. There is no intradialytic hypotension during the study period. However, intradialytic symptoms in clinical adjustment diy weight is more frequent than B VM method, especially thirst. CONCLUSION The use of BVM tends to decrease dy weight in pediatric chronic hemodialysis patients. Even though, no difference in predialytic blood pressure and intradialytic hypotension. BVM to assess dry weight reduces abnormal intradialytic symptoms, especially thirst. Sofar there is no gold standard to access the accurate dry weight in children.