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International Journal of Nephrology
Volume 2011, Article ID 951391, 5 pages
Review Article

Optimal Hemodialysis Prescription: Do Children Need More Than a Urea Dialysis Dose?

1Nephrology Dialysis Transplantation Children's Unit, University Hospital Hautepierre, Avenue Molière, 67098 Strasbourg, France
2Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, INF 430, 69120 Heidelberg, Germany

Received 11 February 2011; Accepted 15 March 2011

Academic Editor: Franz Schaefer

Copyright © 2011 Fischbach Michel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


When prescribing hemodialysis in children, the clinician should first establish an adequate regimen, before seeking to optimize the treatment (Fischbach et al. 2005). A complete dialysis dose should consist of a urea dialysis dose and a determined convective volume. Intensified and more frequent dialysis regimens should not be considered exclusively as rescue therapy. Interestingly, a recent single-center study demonstrated that frequent on-line HDF provides an optimal dialysis prescription, both in terms of blood pressure control (and therefore avoidance of left ventricular hypertrophy), and catch-up growth, that is, no malnutrition or cachexia and less resistance to growth hormone. Nevertheless, this one-center experience would benefit from a prospective randomized study.