Pediatric Continuous Renal Replacement Therapy

Contributions to Nephrology
Zaccaria Ricci, Stuart L Goldstein

Abstract

Continuous renal replacement therapy (CRRT) and peritoneal dialysis are the preferred forms of dialysis delivery in critically ill children for the treatment of severe acute kidney injury. The epidemiology and the outcome of acute pediatric dialysis will be reviewed. The prospective pediatric CRRT (pCRRT) registry has provided important epidemiologic information: pCRRT is required in about 5% of patients in pediatric intensive care units, and the mortality rate of these patients is about 60%. CRRT outcomes are significantly associated with age, the presence of multiple organ dysfunction syndrome and the amount of fluid overload in children before CRRT inception. The timing and the dose of pCRRT are to be further evaluated in prospective trials. A final aspect worthy of review is a technical issue: the accuracy of new-generation CRRT monitors and novel dedicated circuits that have been developed. In future years, the delivery and the outcome of pCRRT are expected to significantly improve, with the target of expanding and anticipating dialysis initiation in critically ill pediatric patients.

Citations

Mar 20, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Lara de GalassoIsabella Guzzo
Apr 26, 2020·Current Opinion in Pediatrics·Keia R Sanderson, Lyndsay A Harshman
May 10, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Zaccaria RicciClaudio Ronco
Dec 21, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Joop JonckheerElisabeth De Waele
May 23, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Francesco GarzottoClaudio Ronco
Apr 12, 2017·Critical Care : the Official Journal of the Critical Care Forum·William R ClarkClaudio Ronco
Dec 5, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Pallavi ChoudharyArchana Thakur
Feb 9, 2021·Critical Care Medicine·Rinaldo BellomoJohn A Kellum
Mar 24, 2021·Critical Care Clinics·Zaccaria RicciClaudio Ronco
Aug 10, 2019·The Journal of Thoracic and Cardiovascular Surgery·Daniel L HamesJoshua W Salvin

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