1 Department of Pediatrics, University of Pittsburgh, School of Medicine, Pittsburgh 13, Pennsylvania
AN EXTENSIVE experience has been reported on use of the artificial kidney in adults. In contrast, two reports concerning 10 patients comprise the bulk of published experience in the pediatric age period. None of the children in these reports was less than 5 years old. This discrepancy suggests either that clinical situations requiring dialysis are less frequent in children or a more suitable alternate means of dialysis is available for children, or both.
The artificial kidney is used in four clinical circumstances in adults: 1) acute tubular necrosis from prolonged shock, nephrotoxic poisons, drug sensitization and hemolysis, 2) acute glomerular failure associated with acute glomerulonephritis, cortical necrosis, thrombotic thrombopenic purpura and other acute vascular disorders; 3) acute renal failure in patients with chronic renal disease in whom decompensation results from a reversible state, such as an infection; 4) acute poisoning with a dialyzable agent.