{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:34:38Z","timestamp":1787762078919,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>\n                    The use of high reflux dialyzers to achieve a Kt\/V\n                    <jats:sub>urea<\/jats:sub>\n                    above 1.2 did not improve patient survival in most literature reports. After an electronic search in many sites, guidelines, systematic reviews, and review articles (cited references): We recommend (1) using the equilibrated double-pool, weekly rather than per session, Kt\/V\n                    <jats:sub>urea<\/jats:sub>\n                    , (2) Use of UF-dry weight to avoid V changes, (3) consider protein catabolic Rate (4) Use of double pool to avoid urea generation rebound effect. Beyond the urea model, other recommended parameters include the middle molecule clearance and patient clinical data as blood pressure control, normal ventricular morphology, and function, absence of anemia, bone mineral disease, vascular calcifications, good nutrition and growth, long-lasting vascular access, less intra-dialysis hypotension, fewer hospitalizations related to complications as infection, long-term patient survival with better life quality. All mentioned parameters are the good markers for adequate dialysis. Since (1) frequent short and (or) slow long dialysis sessions show better solute clearance and hemodynamic stability associated with better control of cardiovascular and bone disease, anemia, nutrition, and growth with better quality of life and survival. (2) The spare in the cost of the antihypertensive medications, erythroid-stimulating drugs, phosphate binders, and frequent hospitalization, compensates for the high dialysis cost. (3) The use of some advisable techniques can minimize access trauma; therefore, HD Model can be changeable according to each patient\u2019s clinical and biochemical follow-up dialysis adequacy progress pattern.\n                  <\/jats:p>","DOI":"10.4103\/1319-2442.379031","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T06:38:15Z","timestamp":1686983895000},"page":"323-329","source":"Crossref","is-referenced-by-count":1,"title":["Update on Pediatric Hemodialysis Adequacy"],"prefix":"10.4103","volume":"33","author":[{"given":"Bahia H.","family":"Moustafa","sequence":"first","affiliation":[{"name":"Department of Pediatric Nephrology, Dialysis\/Transplantation Unit, Faculty of Medicine, Cairo University Children Hospital, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Khaled","family":"ElHatw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northern Area Armed Forces Hospital, Hafr Al Batin, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihab S.","family":"Shaheen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Royal Hospital for Children, Glasgow, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"R1-20230720","doi-asserted-by":"crossref","first-page":"839","DOI":"10.2215\/CJN.08460816","article-title":"The use of a multidimensional measure of dialysis adequacy-moving beyond small solute kinetics","volume":"12","author":"Perl","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"key":"R2-20230720","doi-asserted-by":"crossref","first-page":"821","DOI":"10.2215\/CJN.08171109","article-title":"Dose of dialysis based on body surface area is markedly less in younger children than in older adolescents","volume":"5","author":"Daugirdas","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"R3-20230720","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/ndt\/gfx039","article-title":"Urea and chronic kidney disease: The comeback of the century? 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