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    Hemodialysis — targeting growth and cardiovascular health

    Hemodialysis (HD) is also a treatment option for children with chronic kidney disease. Older children and adolescents eventually prefer HD to PD because it affects less their body image than a PD catheter.

    Children with kidney disease can have malnutrition and growth retardation and they are prone to cardiovascular disease just as adult dialysis patients1. These children are committed to a lifetime of renal replacement therapy and as many of the cardiovascular effects of dialysis are cumulative, optimization of dialysis therapy in children is very important.

    Hemodiafiltration (HDF) – the recommended course of action

    Fresenius Medical Care — 5008 CorDiax paediatric screen saver
    5008 — pediatric version

    There is growing evidence that Hemodiafiltration (HDF) is the most effective way to prevent cardiovascular disease in children and to support growth2,3,4.

    The 5008 Paed machine makes the highly efficient HDF therapy also accessible for children.

    With 5008 Paed Fresenius Medical Care offers a proven system to treat young patients starting from 10 kg of body weight. All components of the system, dialysis machine, blood line and the dialyzers have been tested to perfectly work together as an entity.

    With our 5008 Paed therapy system we are offering solutions for the specific challenges associated to HD in pediatric patients:

     

    • Management of low volumes
    • Best therapy outcome
    • Wellbeing during treatment
    • Additional safety features
    • Best handling and smart accessories 

    Managing low volumes

    Fresenius Medical Care — Pediatric dialysis device
    5008 Paed dialysis device

    Management of low volumes:

     

    • Sensitive machine settings and limits
    • Blood flow limited according to body weight
    • Reduced bolus rate according to blood flow
    • Reduced blood flow of 50ml/min for a gentle start of dialysis
    • Adapted air and microbubble detection sensitivity
    • Pediatric User setup
    • Pediatric AV blood line set with reduced fill volume of 114 ml

    The 5008 Paed software allows adjusting therapeutic parameters and thresholds within pediatric ranges, for example:

    • Reinfusion volume to be chosen within the range of 60 - 480 ml
    • Ultrafiltration rate to be limited until max. 1500ml/h
    • Heparin rate to be set within the range of 0.5-10 ml/h 

    Best therapy outcome

    Targeting best therapy outcomes with 5008 Paed Pediatic

     

    • ONLINE HDF with AutoSub plus and FX CorDiax 40 aims at maximizing substitution volume also at low blood flows to achieve clearance goals
    • Reduced extracorporeal blood volume with special pediatric blood lines and small dialyzers (FX paed, FX CorDiax 40 /50)
    • BCM-Body Composition Monitor: bioimpedance spectroscopy to define dry weight and “V”; validated for children with a body weight of ≥11 kg 

    Dialyzers with reduced volume

    Special dialyzers FX paed FX CorDiax 40
    Effective surface area 0.2 m² 0.6 m²
    Blood priming volume 18 ml 32 ml
    Recommended blood flow range 30-100 ml/min 50-200 ml/min
    Membrane Helixone® Helixone® plus
    Application HD HD/HF/HDF
    Sterilization method INLINE steam  

    Wellbeing during treatment

    Fresenius Medical Care — Blood Volume Monitor
    Blood Volume Monitor
    • The BVM - blood volume monitor helps to maintain hemodynamic stability during treatment
    • Preset inflation pressure of BPM cuff for pain-less blood pressure measurements

    Additional safety features

    • Higher probability of early detection of venous needle dislocation with the VAM – Venous Access Monitor (Standard)
    • Increased safety for active children with the VenAcc device to determine venous needle disconnection (Option)
    • Nonhazardous phtalate-free bloodlines

    Best handling and clever accessories adapted to pediatric use

    The 5008 Paed Paediatric therapy system is known for its intuitive user-guidance philosophy:

    • Centralized operation and information via a spacious touchscreen
    • Simple and logical data entry
    • Sophisticated, stress-free handling of alarms during treatment
    • Easier in-house training with the new mode for simulation of blood detection 

    Fresenius Medical Care — CorDiax Filter Dialyzer Holder
    CorDiax Filter Dialyzer Holder
    Fresenius Medical Care — BPM Blood Pressure Measurement cuff
    BPM Blood Pressure Measurement cuff:
    • Holder for small dialyzer
    • BPM blood pressure measurement cuff for children with an arm circumference of 13-20 cm

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    1 Chavers BM, Li S, Collins AJ, Herzog CA. Cardiovascular disease in pediatric chronic dialysis patients. Kidney International 2002; 62(2):648-653.

    2 Fischbach M, Terzic J, Menouer S, Dheu C, Soskin S, Helmstetter A et al. Intensified and daily hemodialysis in children might improve statural growth. Pediatric Nephrology 2006; 21(11):1746-1752.

    3 Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A. Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrology Dialysis Transplantation 2010; 25(3):867-873.

    4 Schaefer F. Daily online haemodiafiltration: the perfect 'stimulus package' to induce growth? Nephrology Dialysis Transplantation 2010; 25(3):658-660.

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