The CARI Guidelines – Caring for Australians with Renal Impairment Nutrition and Growth in Kidney Disease (December 2005) Dialysis adequacy in children Date written: May 2004 Final submission: January 2005 Author: Elisabeth Hodson GUIDELINES No recommendations possible based on Level I or II evidence SUGGESTIONS FOR CLINICAL CARE (Suggestions are based on Level III and IV sources) • In the absence of adequate data relating dialysis dose to outcomes in children, delivered doses of dialysis for children for both peritoneal and haemodialysis should at least equal doses recommended for adult patients. Background No data exist in children to show that reduced dialysis dose correlates with increased morbidity and mortality. It is generally recommended that delivered doses of dialysis in children should be the same as or above those recommended for adults, pending more data. The objectives of this guideline are to review the available evidence for the relationship between dialysis adequacy and growth in children with end-stage kidney disease (ESKD). Search strategy Databases searched: Medline (1996 to November Week 2 2003) and Embase (1980 to November 2003). MeSH terms for kidney disease were combined with MeSH terms and text words for dialysis adequacy. The Cochrane Renal Group Specialised Register of randomised controlled trials was also searched for relevant trials not indexed in Medline. Date of searches: 1 December 2003.