Assessment of dialysis adequacy using urea reduction ratio and KT/V in four pediatric hemodialysis centers in Baghdad

Background: The 21[st] century has been set to enhance dialysis adequacy. Numerous studies have confirmed the association between the delivered dose of hemodialysis and patients outcomes. There is thus some evidence regarding the relationship between dialysis dose and quality of life

Objective: To assess dialysis adequacy using [Urea Reduction Rate and KT/V], and to determine the association between dialysis dose and different Hemodialysis characteristics in children with End Stage Renal Failure undergoing Hemodialysis

Method: This was an observational cross-sectional study that was conducted for three months, from [November 2014 till January 2015]; we enrolled 50 children with End Stage Renal Failure in four hemodialysis centers in Baghdad. Samples for blood urea [predialysis and postdialysis] were drown to calculate the adequacy dose

Results: Thirty two [64%] of patients were male and 18 [36%] were females; with male to female ratio was [1.7:1].The mean urea reduction ratio and Kt/V were 59.63 +/- 7.345% and 1.29 + 0.275, respectively, with fair dialysis adequacy .A Kt/V less than 1.2 and a urea reduction ratio less than 65% were found in 42%, and 38% of the hemodialysis patients, respectively. There was a significant correlation between dialysis dose and [Blood flow rate, Dialysis hours, Dialysis frequency /week and Effective surface area], while there was insignificance correlation with [gender, age, volume of ultrafiltration

Conclusion: Our results were better than neighbor countries with fair dialysis adequacy. It is important to regularly measure the parameters of dialysis adequacy in order to assess whether targets are achieved in accordance with K/DOQI guidelines

Childhood nephritic syndrome clinical manifestations and histopathlogical spectrum

Nephrotic syndrome in children is a clinical manifestation of different histopathological subtypes. The objectives were to study the different histopathological subtypes of idiopathic nephrotic syndrome and to study their clinical and biochemical parameters at the time of diagnosis for children admitted to Children Welfare Teaching Hospital. A Retrospective study was done on 160 children with idiopathic nephrotic syndrome who were diagnosed and/or treated at Children Welfare Teaching Hospital and were followed up in the pediatric nephrology consultation clinic between April 2004 and April 2006. The study group included 40 children with idiopathic nephrotic syndrome who underwent renal biopsy. There were 26[68.7%] males and 14 [31.2%] females. Age at onset ranged between [1-15] years, median age [3.5] years. Facial oedema was found in 90%, hypertension in 45% patients, gross hematuna in 27.5% and persistent microhematuria in 45%. Sixteen [40%] patients had focal and segmental glomerulosclerosis on renal biopsy, nine [22.5%] patients minimal change nephrotic syndrome, eight [20%] patients mesangioproliferative glomerulonephritis, and seven [17.5%] patients had membranoproliferative glomerulonephritis. Focal and segmental glomerulosclerosis was the most common histopathological subtype in our study group. Further large studies is needed to find out changing trends of histopathology in childhood nephrotic syndrome