{"id":"2fbbcd8b01f8","type":"article","url":"https://hartvaat.nl/2026/03/01/tijd-voor-een-vijfde-pijler-bij-lichamelijk-onderzoek-van-kinderen-aan-dialyse/","title":"Tijd voor een vijfde pijler bij lichamelijk onderzoek van kinderen aan dialyse?","title_en":"Is it time to add a fifth pillar to the physical examination in pediatric dialysis?","category":"chronische nierziekte","category_label":"Nierziekte","professions":["internist"],"tags":[],"journal":"Kidney International","doi":"https://www.kidney-international.org/article/S0085-2538(25)00991-3/fulltext","source_url":"https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00991-3/fulltext","authors":["Mohamed Nassiri","Fernando Parra-Londoño","Víctor López-Baez","Pedro Arango-Sancho","Yolanda Calzada-Baños","Cristina Aguilar","Álvaro Madrid-Aris","Claudio Ronco","Gregorio Romero-González"],"significance":4,"published":"2026-03-01","source_date":"2026-03-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This commentary discusses whether it is time to add a fifth pillar to the physical examination in paediatric dialysis, emphasising the high cardiovascular burden and the need for early, personalised preventive strategies targeting fluid overload and hypertension.","created":"2026-07-03T10:25:16Z","updated":"2026-07-03T13:24:42Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Shroff en Schaefer benadrukken de hoge cardiovasculaire belasting bij kinderen aan dialyse en de noodzaak van vroege, gepersonaliseerde preventie. Vochtoverlast en hypertensie zijn belangrijke modificeerbare risicofactoren. Dit commentaar pleit voor uitbreiding van het lichamelijk onderzoek.","abstract_original":"Shroff and Schaefer emphasize the high cardiovascular burden among children receiving dialysis and the need for early, personalized preventive strategies.1 As they point out, fluid overload and hypertension are key modifiable risk factors driving left ventricular hypertrophy and underscoring the central role of volume management.1 Fluid overload and intradialytic variability remain major cardiovascular risks: hypervolemia promotes hypertension, arterial stiffness, and left ventricular hypertrophy, whereas excessive ultrafiltration predisposes to hypotension and repetitive ischemia."}