Interdialytic weight gain in oligoanuric children and adolescents on chronic hemodialysis

Pediatr Nephrol. 2015 Jun;30(6):999-1005. doi: 10.1007/s00467-014-3005-2. Epub 2014 Nov 15.

Abstract

Background: Little is known about the clinical impact of interdialytic weight gain (IDWG) on oligoanuric children undergoing chronic hemodialysis (HD).

Methods: We retrospectively assessed IDWG, left ventricular mass index (LVMI) and its changes (ΔLVMI), pre-HD systolic and diastolic blood pressure (DBP), residual urine output, Kt/V, the frequency of intradialytic symptoms, normalized protein catabolic rate, and the 3-month change in the dry weight of 16 hemodialyzed oligoanuric patients with a median age of 14.8 years (range 5.0-17.9).

Results: There was a significant correlation between IDWG and median LVMI (r 0.55, p = 0.026), which was 27.3 g/m(2.7) (22.5-37.6) in the patients with a median IDWG of <4 %, and 44.3 g/m(2.7) (28.2-68.7) in those with a median IDWG of >4 % (p = 0.003). None of the four patients with an IDWG of <4 % showed left ventricular hypertrophy, compared with 10 of the 12 patients (83.3 %) with an IDWG of >4 % (p = 0.003); the former also had a better median ΔLVMI (-33.5 % vs -13.0 %; p = 0.02) and a lower median DBP sds (0.24 vs 1.72, p = 0.04).

Conclusions: There is a significant correlation between IDWG and LVMI in pediatric oligoanuric patients on chronic HD: those with an IDWG of >4 % are at a higher risk of left ventricular hypertrophy.

MeSH terms

  • Adolescent
  • Anuria / complications
  • Anuria / diagnosis
  • Anuria / physiopathology*
  • Blood Pressure
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / etiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Oliguria / complications
  • Oliguria / diagnosis
  • Oliguria / physiopathology*
  • Renal Dialysis* / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urination
  • Weight Gain*
  • Young Adult