https://www.selleckchem.com/products/gw3965.html Hemodialysis (HD) dose targets and ultrafiltration rate (UFR) limits for pediatric patients on chronic HD are not known and are derived from adults (spKt/V>1.4 and <13 ml/kg/h). We aimed to characterize how delivered HD dose and UFR are associated with survival in a large cohort of patients who started HD in childhood. Retrospective analysis on a cohort of patients <30 years, on chronic HD since childhood (<19 years), having received thrice-weekly HD 2004-2016 in outpatient DaVita centers. Survival while remaining on HD. (I) primary analysis mean delivered dialysis dose stratified as spKt/V ≤1.4/1.4-1.6/>1.6 (Kaplan-Meier analysis), (II) secondary analyses UFR and alternative dialysis adequacy measures [eKt/V, body-surface normalized Kt/BSA] on continuous scale (Weibull regression model). A total of 1780 patients were included (age at the start of HD 0-12y n=321, >12-18y n=1459; median spKt/V=1.55, eKt/V=1.31, Kt/BSA=31.2 L/m , UFR=10.6 mL/kg/h). (I) spKt/V<1.4 was associated with lower survival compared to spKt/V>1.4-1.6 (P<0.001, log-rank test), and spKt/V>1.6 (P<0.001), with 10-year survival of 69.3% (59.4-80.9%) versus 83.0% (76.8-89.8%) and 84.0% (79.6-88.5%), respectively. (II) Kt/BSA was a better predictor of survival than spKt/V or eKt/V. UFR was additionally associated with survival (P<0.001), with increased mortality <10/>18 mL/kg/h. Associations did not alter significantly following adjustment for demographic characteristics (age, etiology of kidney disease, and ethnicity). Our results suggest usefulness of targeting Kt/BSA>30 L/m for best long-term outcomes, corresponding to spKt/V>1.4 (>12 years) and >1.6 (<12 years). In contrast to adults, higher UFR of 10-18 ml/kg/h was not associated with greater mortality in this population. 1.6 ( less then 12 years). In contrast to adults, higher UFR of 10-18 ml/kg/h was not associated with greater mortality in this population. Ultrafiltration (UF) is used for fluid