**3. Indications for initiating acute dialysis in children**

The decision to initiate acute dialysis depends first on fluid balance, degree of azotemia, electrolyte disturbances, and acid-base metabolism.

In addition to renal causes (e.g., hemolytic uremic syndrome) or hemodynamic causes (after cardiac intervention for congenital heart disease), in rare cases indications for acute dialysis are also intoxication (ethylene glycol, barbiturates) or a metabolic disorder (urea cycle deficits and hyperammonemia).

For HD, HF, and HDF a central venous access with a large light is placed by the resuscitator. The size of the central catheter depends on the weight of the child (**Table 2**).

In low-weight newborns with problems getting blood to them, using two singlelumen catheters in two different veins is an efficient alternative [8].


**Table 2.**

*Choice of bilumeric dialysis catheter size by child's weight.*
