ISN WCN 2020, ABU DHABI, UAE

hypertrophy), or with elements of CKD-MBD (Vitamin D, iPTH, Ca, P, increased emphasis on long-term health. This systematic review sum-
CaXP) we found no correlation. sKlotho showed a positive correlation marizes the available literature on HD, in terms of indication, technical
with hemodialysis efficiency (eKTV) (r¼0.26, p-0.04), but no correlation aspects and outcomes. Ultimately, this data can help to guide safe,
with hemodialysis duration. effective HD treatment in children and in formulating guidelines for
When we classified patients according to median sKlotho level, we best practice.
found out that patients with sKlotho> 333.398 pg/ml had significantly
higher level of hemoglobin (11.2 vs. 10.6 g/dl, p¼0.017). Patients with
higher levels of sKlotho showed a decreased risk of mortality, however SAT-233
not statistically significant. We found a higher risk of all cause mor- A MOBILE APPLICATION TO MEASURE
tality in patients with diabetes mellitus (OR 6.9, 95% CI- 1.6924 to STRENGTH AND STATES OF A GRIP BALL
28.1469, p¼0.007) and with left ventricular hypertrophy (OR 12.4, ON VASCULAR ACCESS CARE
95% CI- 1.5135 to 102.9073, p¼0.01).
Conclusions: In our study, higher levels of sKlotho were associated to a CHEN MD, CL*1, Chang, CM2, Chung, CR2, Shen, SF3, Chiang, YR4,
better controlled anemia, a better hemodialysis efficiency, the absence Yang, WC5, Horng, JT2
1
of signs of coronary heart disease on ECG, but not with an increased 2 Landseed International Hospital Division of Nephrology Taoyuan City
year survival in hemodialysis patients. Taiwan, 2National Central University Department of Computer Science and
Information Engineering Taoyuan Taiwan, 3National Central University
Physical Education Office Taoyuan Taiwan, 4Ming Chuan University
SAT-232 Biotechnology Taoyuan Taiwan, 5Landseed International Hospital Kidney
Disease Integrated Care Center Taoyuan Taiwan
HEMODIALYSIS IN CHILDREN AND
Introduction: Chronic hemodialysis patients need proper hand grip
ADOLESCENTS: A SYSTEMATIC REVIEW
1 2 2 3
exercise to increase blood vessel diameter and blood flow, enhance
CHANCHLANI, R , Young, C , Farooq, A , Sangar, S , vascular maturation, improve the success rate of vascular access sur-
Sethi, S4, Raina, R*5 gery, and maintain the vascular patency. Through wearable device,
1
McMaster Children's Hospital Department of Pediatrics- Division of Pedi- grip ball’s state can be obtained in a convenient way.
atric Nephrology Hamilton Canada, 2McMaster University Michael De Our study is designed to acquire grip force and number of presses
Groote School of Medicine Hamilton Canada, 3McMaster University Health when grip ball and keep information to ensure appropriate hand grip
Sciences Library Hamilton Canada, 4Medanta Medicity Pediatrics New Delhi exercise for hemodialysis patients through instant feedback of grip
India, 5Cleveland Clinic Pediatrics Ohio USA
strength and number of presses.
Introduction: Hemodialysis (HD) in children is often utilized in Methods: The power sensor is used to obtain the voltage difference data
situations such as acute or chronic kidney disease, severe electrolyte during hand grip exercise, and the smart device is used to calculate the
imbalance, toxicities, and hyperammonemia. Proper HD in children grip strength and the number of presses. This study was evaluated with
require careful manipulation of technical parameters including blood SAEHAN grip force meter and actual value of press count by 4 vol-
and dialysate flow rate, type/size of dialyzer and dialysate compo- unteers. Total 198 person-times data were collected and analyzed. Then,
sition. Although general principles of hemodialysis are similar be- data can be stored in the server for healthcare research analysis. The
tween adults and children, there are several unique aspects of HD power sensor is used to obtain the voltage difference data during hand
inherent to the pediatric population. Issues of hemodynamic sta- grip exercise, and the smart device is used to calculate the grip strength
bility, obtaining ideal vascular access and preventing complications and the number of presses. This study was evaluated with SAEHAN
from HD can prove challenging in this patient population. In this grip force meter and actual value of press count by 4 volunteers. Total
systematic review, we evaluate the existing literature regarding the 198 person-times data were collected and analyzed. Then, data can be
use of hemodialysis in children and young adults (ages 1-20 years). stored in the server for healthcare research analysis.
Furthermore, we summarize this data to compile guidelines for best
practice.
Methods: A systematic search of all relevant studies and abstracts
was conducted using several electronic databasesby utilizing
appropriate key words by an expert hospital librarian. Eligible
studies included children aged 1-20 years with acute or chronic
indications for hemodialysis. Studies prior to Jan 1990 or on
continuous renal replacement therapy, peritoneal dialysis, modified
forms of hemodialysis (nocturnal, hemodiafiltration, etc.) were
excluded. In addition, studies that were non-English or involved <
5 patients were excluded. Titles and abstracts were screened by two
independent reviewers, followed by a full text review of included
articles. Data on HD indications, specific parameters of the HD
protocol, including dialysate composition, dialysate flow, blood flow,
urea reduction rate and ultrafiltration goals were collected. We also
collected data regarding medications, anticoagulation and blood
transfusions required along with outcomes such as mortality and
kidney transplantation.
Results: Preliminary results of this systematic search returned a total
number of 16,196 papers. After screening for relevant titles and
abstracts, and exclusion based on criteria defined above, a total of
102 papers remained. Further assessment of full text of articles led
to inclusion of 55 papers in this review. Results showed that
congenital abnormalities, glomerulopathy and obstructive uropathy
were some of the most common indications of HD. The mean age of
HD was 12.7 2.9 years. Mean dialysis session duration was 223.7
65.6 min/session, with 3.2 0.6 sessions/week. Mean dialysate
flow was 48046.8 ml/min and mean blood flow was 192.565.5
ml/min. A subset of studies (n¼5) reported mean blood flow rela-
tive to body weight as 4.70.5 ml/kg/min. Mean urea reduction
ratio was 44.930.0%. Most common types of vascular access were
central venous catheters and arteriovenous fistulas. The most com- Results: The results of this study are evaluated with SAEHAN grip
mon complications were access-related infection and thrombosis. force meter and actual value of press count. According to the built-in
From studies with reported outcomes, 7.68% of children died and sensor, the error of grip strength and pressing frequency is -0.28  1.43
42% were transplanted. kg and -1.7  1.42, respectively. Both are within 4%. The medical team
Conclusions: The use of HD in children presents unique challenges due can browse the data bank for real-time status of vascular access reha-
to age-related differences in physiology, risk of complications and bilitation and make improvement recommendations promptly.

Kidney International Reports (2020) 5, S1–S392 S99