Renal Replacement Therapy

Miller Children’s works with DaVita, a nationwide renal therapy care service, to provide quality renal care therapy to patients with acute or chronic renal failure. Renal replacement therapy, or dialysis, is used when kidneys no longer work well enough to keep the body healthy. The use of dialysis depends on each child’s health and condition. All patients are in a comfortable setting during therapy in the hospital and a specially trained staff will make sure comfort is a priority.

Hemodialysis

Hemodialysis is performed in the hospital by trained health care professionals. The child lies on the bed comfortably while the dialysis machine, also called a dialyzer, removes extra wastes and fluids from the blood that travels through a tube. Once clean, the dialyzer sends the blood back to the patient through another tube. This form of dialysis is done three times a week and can last up to four hours.

Peritoneal Dialysis

Peritoneal Dialysis (PD) is a more common method for kids and its use depends on the child’s health and kidney condition. Unlike hemodialysis, which cleans wastes from the blood outside of the body, PD uses a membrane in the child’s abdomen, called the peritoneum, as a filter. A dialysis fluid, called dialysate, is placed in the peritoneum cavity where the membrane helps pull wastes through.

To begin PD, a special catheter is placed in the child’s lower abdomen near the navel. After the catheter is placed, the child and family will be educated by a trained DaVita health care professional on the process of introducing dialysate and replacing it with fresh dialysis fluid. Home treatments usually begin two to three weeks after the catheter has been placed and training is complete.

Continuous Veno-Venous Hemofiltration (CVVH)

Miller Children’s also provides kidney care to the pediatric intensive care unit (PICU) where trained Miller Children’s staff provides continuous renal replacement therapy. CVVH, much like peritoneal dialysis and hemodialysis, provides a method of cleansing waste and toxin from the patients’ blood, but because it is continuous, rather than intermittent, this form of therapy is best for young patients in critical care.