"PEDIATRIC HEMOPERFUSION-AUGMENTED HEMODIALYSIS: ENHANCING OUTCOMES BEYOND CONVENTIONAL HEMODIALYSIS."

 

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"PEDIATRIC HEMOPERFUSION-AUGMENTED HEMODIALYSIS: ENHANCING OUTCOMES BEYOND CONVENTIONAL HEMODIALYSIS."

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SHIVANGI
PURI
SHIVANGI PURI shivangipuri1067@gmail.com Sir Gangaram Hospital Pediatric Nephrology Delhi India *
KANAV ANAND dr_kanav_anand@yahoo.co.uk Sir Gangaram Hospital Pediatric Nephrology Delhi India -
ANSHU ARORA aroraanshu266@gmail.com SIR GANGARAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DAMINI KHARKWAL daminikharkwal15@gmail.com SIR GANGARAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
VIVEK KUMAR 955vivekkumar@gmail.com SIR GANGARAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
SHUBHAM MITTAL shubhammittal962@gmail.com SIR GANGARAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
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To assess the efficacy of adjunctive hemoperfusion (HP) in improving toxin clearance, systemic inflammation and clinical outcomes in children with chronic kidney disease (CKD) undergoing maintenance hemodialysis (M-HD).

Five children (median age 13.2 years, range 10–16) on adequate M-HD, but with resistant hypertension, persistent pruritus, sleep disturbances or reduced appetite, were prospectively enrolled from June 2025. HP was integrated into HD session once weekly for 1 month then tapered to biweekly in second month. The HP treatment was conducted using Jafron HA 130 filter. Clinical outcomes- blood pressure, antihypertensive requirement, pruritus scores (Visual Analog Scale), sleep quality (Epworth Sleepiness Scale- EPSS) and quality of life (KDQOL- SF 1.3). Laboratory outcomes- serum β2-microglobulin (β2-MG) and interleukin-6 (IL-6) measured at baseline and over time. Data are expressed as mean ± SD, with trends analysed using repeated-measures ANOVA.

Mean baseline serum β2-MG (38.14 ± 5.1 mg/L) showed significant reduction to 31.8 ± 4.3 at 2 weeks, 30.1 ± 3.9 at 4 weeks and 31.3 ± 4.0 at 6 weeks (p=0.02). IL-6 declined from 34.2 ± 6.2 pg/mL at baseline to 12.1 ± 3.1, 11.3 ± 2.7, and 8.9 ± 2.5 at 2, 4 and 6 weeks respectively (p<0.001). The mean number of antihypertensives decreased from 4.0 ± 0.7 to 2.2 ± 0.4 (p=0.01). EPSS scores dropped from 14.8 ± 2.1 to 8.6 ± 1.7 (p=0.008) while pruritus scores improved from 8.0 ± 1.3 to 4.8 ± 0.9 (p=0.01). KDQOL- SF 1.3 domains of physical functioning, vitality and emotional well-being each improved by >20% compared to baseline.

There is a paucity of published data on the use of HP in pediatric CKD patients on M-HD. In this study, adjunctive HP with M-HD showed statistically significant reductions in serum β2-MG, IL-6, improved blood pressure control, enhanced sleep, pruritus outcomes and improvements in quality of life supporting HP as a promising adjunct therapy by providing biochemical and symptomatic relief in addition to better long-term cardiovascular and neurocognitive outcomes in CKD patients.

Kewords