Dialyzer characteristics, options, and considerations for pediatric hemodialysis

Dialyzer characteristic	Range of options	Considerations
Surface area	0.2 m² to 2.5 m²	Larger surface gives greater capacity for clearance and ultrafiltration but requires high blood flow to achieve these advantages
Priming volume	18 mL to 140 mL	Consider along with tubing set volume to determine maximum safe extracorporeal volume, especially for smaller patients
Membrane material	Cellulosic Modified cellulose Artificial	Cellulosic membranes considered less bio-compatible and may lead to more allergic-type reactions Greater bio-compatibility with progression to modified cellulose and then to artificial (plastic) membranes
Sterilization	ETO Gamma irradiation Steam Electron beam	Allergic reactions associated with ETO Fewer reactions with gamma and steam
Flux	Low flux versus high flux	Higher flux dialyzers have higher permeability (eg, larger pores), permitting higher rates of middle molecule clearance and higher UF rate at a given prescription
Clearance (typically described as K_D for urea (mL/min) at Q_B 200 mL/min)	K₀A urea 170 mL/min to 1700 mL/min	Varies with surface area, flux, membrane material
Ultrafiltration capability (K_UF mL/hr/mmHg)	K_UF 7 mL/hr/mmHg to 111 mL/hr/mmHg	Varies with surface area, flux, membrane material

This table summarizes dialyzer characteristics, options, and considerations for HD in children. For additional details, refer to separate UpToDate content on hemodialysis in children.

HD: hemodialysis; ETO: ethylene oxide; UF: ultrafiltration; K_D: dialyzer clearance; Q_B: blood flow rate; K₀A: permeability surface area product; K_UF: ultrafiltration coefficient.

Graphic 141887 Version 1.0

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Dialyzer characteristics, options, and considerations for pediatric hemodialysis