New research aims to reduce complications in children on haemodialysis

07 July 2023

Dr Claudio Capelli’s work is supported by a co-funded grant of £81,000, between Kidney Research UK and the National Institute for Health Research (NIHR).

The problem

As kidney function declines patients may need kidney replacement therapy. This either involves dialysis, using a machine to clean the blood, or a kidney transplant. Finding a suitable kidney for transplant can be a slow process, and children are often on dialysis for long periods of time.

Central venous lines (CVLs) are tubes that are inserted into a vein and left in to allow access to blood for dialysis. However, so far, the CVLs do not work well in children and patients often require multiple lines to be replaced. Claudio thinks that it is now time to rethink the CVL designs, putting children and their features at the centre of innovation in this field.

Dr Claudio Capelli

The solution

Claudio and his team want to use engineering software, computer analyses and experiments in the lab to redesign CVLs specifically for use in children. They will adapt their design to be better suited to children; this project aims to reduce complications, improving the experience of being on dialysis.

What this might mean for kidney patients

CVLs that have been designed specifically for children could lead to dialysis that is safer and more effective. Importantly, children will also likely spend less time in hospital due to complications.

“After having many complications with my son whilst on dialysis, including many infections and being told his line may have to be removed and a new one inserted, I feel this new research may help other children avoid similar issues and improve the dialysis journey.” Tori Amos, parent of a young kidney patient.

Update from the team

Claudio and the team have new results published in the ASAIO journal to understand which parts of CVL designs matter most for their performance in children.

"Our results show that the most proximal side holes (the ones farthest from the catheter tip opening) are especially important for how blood is exchanged at the tip of the catheter. If designed poorly, they can cause blockages, turbulence, or damage to blood cells. If designed well, they can improve blood flow, reduce the stress on blood cells, and make catheters last longer. For patients, especially children who rely on heamodialysis, this could mean fewer catheter problems, fewer replacements, and safer, more effective treatment.

The next step is to use what we learned to design new catheters that are better suited for children rather than simply adapting adult devices. These designs can then be tested in experimental settings, and eventually in clinical studies, to see if they reduce complications and improve quality of life for children on dialysis." Claudia Bruno, PhD student at UCL.