Dialysis and Haemofiltration, also known as ‘Renal Replacement Therapy’, are ways to take over the function of the kidneys. For this type of treatment, your child is connected to a machine that draws blood from a large cannula (usually in the neck or the groin), ‘washes’ the blood by running it through a filter and then returns it via the same cannula.
Reasons to have Dialysis or Haemofiltration
- Your child’s kidney’s have shut down or aren’t working properly
- Some life-threatening poisons can quickly be ‘washed out’ through a ‘kidney machine
What to expect
Most renal replacement therapy in PICU is short-term, required only for a few days. Young children may need medication to keep them calm or we may even need to keep them fully asleep in order for them to be comfortable with being connected to a kidney machine. Older children and young adults are usually fine having this treatment fully awake.
Once connected to the kidney machine, we will thin the blood running through the machine to prevent it from clotting. It is common, however, for the machine’s filter to clot after some time (hours to days). When this happens, we simply stop the machine, change the filter and restart treatment if still needed.
Plasmafiltration
Plasmafiltration is technically very similar to Haemofiltration but uses a different type of filter (the kidneys often work fine in children needing plasmafiltration). In Plasmafilteration, except that blood isn’t merely ‘washed’ but instead the filter removes a straw-coloured portion of the blood (the plasma). The machine then replaces it with clear fluid and clean, fresh plasma from donors (safely supplied, like other blood products, by the Australian Red Cross).
Reasons to have Plasmafiltration
Plasmafiltration is used in a small number of diseases where science has shown that replacing a portion of a child’s plasma may be a cure, for example in a disease called Guillian-Barre-Syndrome.