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The Montreal Children's Hospital
Division of Pediatric Nephrology
Centre universitaire de santé (CUSM) McGill University Health Centre (MUHC)

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Hemodialysis Adequacy: New Directions 

This is a tutorial introduction to urea kinetics in pediatric hemodialysis patients. Although the material also applies to adults, it was not my intention to comment on dialysis in older patients, which is much more developed and comprehensively reviewed elsewhere (see Prescribing Hemodialysis: A Guide to Urea Modeling, T.A. Depner, Kluwer Academic Publishers, 1991 for an excellent introduction). The material here is essentially the contents of two talks I gave at the 11th Annual Pediatric Dialysis Conference (part of the 20th Annual Conference on Dialysis) held in San Francisco on Feb. 27-29, 2000. The two talks were entitled:

1) Current recommendations fall short of optimum hemodialysis dosing in Children (Feb. 27, 2000)

2) Multicompartment urea kinetics in well-dialyzed children (Feb. 28, 2000 as the recipient of the Baxter 2000 Award for Research in Pediatric Dialysis)

Supporting documents include:

  1. Dialysis Adequacy: A tutorial introduction
  2. Growth in maintenance hemodialysis: Impact of optimal nutrition and clearance J Pediatr 1999; 134:464-71
  3. Multicompartment urea kinetics in well-dialyzed children. Kidney International 2000; 58: 2138–46
  4. Early draft of: Reassessing hemodialysis adequacy: The case for more. Pediatr Nephrol, In Press
  5. UreaFit Software: Add-On for Microsoft Excel, implementing variable volume single pool and double pool models (Windows version only)

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These notes and the talks reflect only the opinion of the author. Obviously, I don't speak for my colleagues or our institution.  I'm only too happy to share the modelling software described here. Although I appreciate the postcards I've received, my comment about postcard-ware was intended as a joke i.e.  you shouldn't feel obliged, but it is nice to see pictures of somewhere warm in the middle of a Montreal  winter :)

Atul Sharma MD, FRCP(C)
Pediatric Nephrologist,
Montreal Children's Hospital/McGill University
Montreal, Canada H3H 1P3

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