Bleeding risk for surgical dialysis procedures in children with hemolytic uremic syndrome

Brent R. Weil, Sharon Andreoli, Deborah F. Billmire

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Children with hemolytic uremic syndrome (HUS) frequently develop acute kidney injury (AKI) requiring renal replacement therapy (RRT). Peritoneal dialysis (PD) is commonly used. Despite high rates of thrombocytopenia, there is concern that platelet transfusions may worsen HUS by exacerbating microthrombi formation. We evaluated bleeding risk for PD catheter placement with or without central venous catheter (CVC) placement in children with HUS. Records from 1998 to 2007 were searched. Data regarding patient demographics, PD catheter placement, CVC placement, occurrence of procedure-associated bleeding, and time from insertion to removal of PD catheter were collected. Patients were stratified according to those who received and those who did not receive platelet transfusions. Seventy-three patients were identified. Twenty-two (30%) patients received platelet transfusion while 51 (70%) did not. Mean preoperative platelet counts were 37,600±21,900/mm3 in patients receiving transfusions and 64,800∈±∈38,800/mm3 in patients not receiving transfusions. Sixty-seven children (92%) also underwent CVC placement. There were no bleeding complications related to these procedures in either group. No differences in time to removal of the PD catheter were detected. Although caution and sound clinical judgment must be exercised, our findings suggest that PD catheter and CVC placement can be accomplished safely in most children with HUS, without need for platelet transfusion in spite of the associated thrombocytopenia.

Original languageEnglish
Pages (from-to)1693-1698
Number of pages6
JournalPediatric Nephrology
Volume25
Issue number9
DOIs
StatePublished - 2010

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Hemolytic-Uremic Syndrome
Peritoneal Dialysis
Dialysis
Platelet Transfusion
Central Venous Catheters
Hemorrhage
Catheters
Thrombocytopenia
Bleeding Time
Renal Replacement Therapy
Platelet Count
Acute Kidney Injury
Demography

Keywords

  • Acute kidney injury
  • Escherichia coli O157:H7
  • Peritoneal dialysis
  • Renal replacement therapy
  • Thrombocytopenia

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Bleeding risk for surgical dialysis procedures in children with hemolytic uremic syndrome. / Weil, Brent R.; Andreoli, Sharon; Billmire, Deborah F.

In: Pediatric Nephrology, Vol. 25, No. 9, 2010, p. 1693-1698.

Research output: Contribution to journalArticle

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