BACKGROUND: The simultaneous use of plasma-exchange (PE) and haemodialysis (HD), known as tandem PE and HD (TPH), may be an additional resource for treating patients who need both therapies at the same time. However, little experience is reported in the paediatric setting. CASE-DIAGNOSIS/TREATMENT: We retrospectively reviewed the TPH sessions performed in the last 5 years in our unit. Thirty-nine TPH treatments in eight pediatric patients were traced. The median age of the patients was 10.5 (range 5.1-19.2) years, and median weight was 27.6 (range 14.7-66.2) kg. Indications for TPH were atypical haemolytic uremic syndrome due to factor H or factor I dysregulation, or to a not yet defined abnormality, in most of the sessions (34/39 sessions). The remaining five sessions were performed for vasculitis, focal segmental glomerulosclerosis and hyperimmunization in a patient waiting for kidney transplant. In all treatments, TPH was completed and reached the desired ultrafiltration and substitution volumes; the duration of PE was shorter than that of HD. No significant adverse events were observed. CONCLUSIONS: In those rare patients who require both PE and HD, TPH can improve their quality of life by reducing the time spent in extracorporeal circulation. This tandem treatment is safe and well-tolerated, even in subjects of relatively small body size.
BACKGROUND: The simultaneous use of plasma-exchange (PE) and haemodialysis (HD), known as tandem PE and HD (TPH), may be an additional resource for treating patients who need both therapies at the same time. However, little experience is reported in the paediatric setting. CASE-DIAGNOSIS/TREATMENT: We retrospectively reviewed the TPH sessions performed in the last 5 years in our unit. Thirty-nine TPH treatments in eight pediatric patients were traced. The median age of the patients was 10.5 (range 5.1-19.2) years, and median weight was 27.6 (range 14.7-66.2) kg. Indications for TPH were atypical haemolytic uremic syndrome due to factor H or factor I dysregulation, or to a not yet defined abnormality, in most of the sessions (34/39 sessions). The remaining five sessions were performed for vasculitis, focal segmental glomerulosclerosis and hyperimmunization in a patient waiting for kidney transplant. In all treatments, TPH was completed and reached the desired ultrafiltration and substitution volumes; the duration of PE was shorter than that of HD. No significant adverse events were observed. CONCLUSIONS: In those rare patients who require both PE and HD, TPH can improve their quality of life by reducing the time spent in extracorporeal circulation. This tandem treatment is safe and well-tolerated, even in subjects of relatively small body size.
Authors: Gema Ariceta; Nesrin Besbas; Sally Johnson; Diana Karpman; Daniel Landau; Christoph Licht; Chantal Loirat; Carmine Pecoraro; C Mark Taylor; Nicole Van de Kar; Johan Vandewalle; Lothar B Zimmerhackl Journal: Pediatr Nephrol Date: 2008-09-18 Impact factor: 3.714
Authors: David R W Jayne; Gill Gaskin; Niels Rasmussen; Daniel Abramowicz; Franco Ferrario; Loic Guillevin; Eduardo Mirapeix; Caroline O S Savage; Renato A Sinico; Coen A Stegeman; Kerstin W Westman; Fokko J van der Woude; Robert A F de Lind van Wijngaarden; Charles D Pusey Journal: J Am Soc Nephrol Date: 2007-06-20 Impact factor: 10.121
Authors: Fabio Paglialonga; Claus Peter Schmitt; Rukshana Shroff; Karel Vondrak; Christoph Aufricht; Alan Rees Watson; Gema Ariceta; Michael Fischbach; Gunter Klaus; Tuula Holtta; Sevcan A Bakkaloglu; Alexandra Zurowska; Augustina Jankauskiene; Johan Vande Walle; Betti Schaefer; Elizabeth Wright; Roy Connell; Alberto Edefonti Journal: Pediatr Nephrol Date: 2014-08-20 Impact factor: 3.714