Background: adequacy of dialysis is very important and has a major impact on morbidity as well as mortality among hemodialysis (HD) children. Many researchers have reported that high flux membrane (HFM) enhances the medium-sized molecules removal while other reports revealed no remarkable effect on them. This study aimed to compare the efficacy of high-flux hemodialysis (HFHD) versus low-flux hemodialysis (LFHD) in HD children.

Patients and methods: In the period from June to December 2023, 50 cases on regular HD for end-stage renal disease included in this retrospective cohort study at the Pediatric nephrology unit, Zagazig University Children's Hospital. Blood samples were collected pre- and post-dialysis and forwarded to the lab for analysis. To evaluate dialysis effectiveness, we employed KT/V, blood urea nitrogen (BUN), as well as urea reduction ratio (URR) parameters.

Results: Post dialysis, a significant difference between the groups concerning the adequacy of HD was found according to URR and KT/V(p<0.001, p=0.008 respectively). According to having URR (≥65%), 56% within HF group versus 24% had adequate HD. While according to KT/V (≥1.2), 72% versus 20% within HFHD and LFHD groups respectively had adequate HD. There was a notable variation between the tested groups in terms of HD sufficiency according to URR and KT/V (p=0.041, p<0.001 respectively).

Conclusion: High-flux hemodialysis demonstrates more successful efficacy in improving biochemical parameters, including URR and KT/V, compared to low-flux hemodialysis in pediatric patients.