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Updated: May 5, 2026
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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[Acute renal replacement therapy in pediatrics]
T Gaillot1, B Ozanne, P Bétrémieux
1Unité de réanimation pédiatrique, pôle anesthésie-réanimation, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35203 Rennes cedex 2, France; CIC-P Inserm 0203, université Rennes-1, 35033 Rennes, France.
Annales Francaises D'Anesthesie Et De Reanimation
|November 20, 2013
Summary
Choosing acute renal replacement therapy for critically ill children requires balancing modality benefits and risks. Continuous renal replacement therapy offers advantages in dialysis dose and fluid control for pediatric intensive care unit patients.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Renal Replacement Therapy
Context:
- Pediatric intensive care units (PICUs) offer various acute renal replacement therapies (ART), including intermittent hemodialysis (IHD), peritoneal dialysis (PD), and continuous renal replacement therapies (CRRT).
- No prospective studies have directly compared the outcomes of different ART modalities in children.
- Treatment decisions are guided by local expertise, available resources, and patient condition.
Purpose:
- To review the available modalities for acute renal replacement therapy in pediatric intensive care units.
- To discuss the advantages and limitations of each modality in critically ill children.
- To inform clinical decision-making regarding ART selection for pediatric patients.
Summary:
- Intermittent hemodialysis (IHD) may cause poor hemodynamic tolerance in critically ill children and requires specialized water circuits, often unavailable in PICUs.
- Peritoneal dialysis (PD) is accessible and cost-effective but may have limited efficacy in severe cases.
- Continuous renal replacement therapies (CRRT) generally allow for higher dialysis doses, better fluid management, and facilitate adequate nutrition delivery.
Impact:
- Highlights the need for prospective studies to guide evidence-based ART selection in pediatric critical care.
- Emphasizes the importance of considering patient-specific factors and resource availability when choosing between IHD, PD, and CRRT.
- Provides a framework for understanding the trade-offs associated with different ART modalities in managing acute kidney injury in critically ill children.
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