Continuous renal replacement therapy in critically ill children: single-center experience

Authors: GÜL HATİCE ERKOL TUNCER, MESİHA EKİM, EMEL OKULU, BEGUM ATASAY, TANIL KENDİRLİ

Abstract: Background/aim: Continuous renal replacement therapy (CRRT) has significant benefits in the treatment of critically ill children. The objective of this study is to describe the treatment indications, methods, demographics, and outcome of the patients who received CRRT in our pediatric intensive care unit and neonatal care unit, and, according to these results, we also aim to make improvements in our unit-based interventions. Material and methods: In this single-centered study, we retrospectively evaluated medical charts of the patients admitted to our intensive care units and received CRRT between February 2010 and November 2015. Results: Fifty of 60 patients were included in this study. Newborns made up 28% (n = 14) of the patients. The mean body weight was 18.4 kg (2.3-98 kg). CRRT indications were fluid overload (30%), acute kidney injury (40%), metabolic disease (24%), electrolyte impairment (4%), and drug intoxication (2%). The most common method of CRRT was continuous venovenous hemodiafiltration (CVVHDF) (72%). The mean duration of CRRT was 135 hours (1-864) and totally 143 filters, polyarylethersulfon (n = 23.46%) and polyacrylonitrile (n = 27.54%) were used. Overall survival was 42%. The survival rate of newborns was significantly higher (P = 0.046). Conclusion: CRRT is a lifesaving method that can be applied to critically ill children with acute kidney injury and fluid overload at any age and weight by experienced teams.

Keywords: Continuous renal replacement therapy, acute kidney injury, critically ill children, fluid overload, hemodiafiltration, hemofiltration

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