Related Experiment Video
Updated: Dec 28, 2025
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Pediatric Continuous Renal Replacement Therapy (PCRRT) expert committee recommendation on prescribing prolonged
Sidharth Kumar Sethi1, Aliza Mittal2, Nikhil Nair3
1Pediatric Nephrology, Medanta, The Medicity, Gurgaon, India.
Insights
Prolonged intermittent renal replacement therapies (PIRRT) offer a cost-effective option for pediatric intensive care. This study provides initial guidelines for PIRRT use in children, addressing its definition, indications, and prescription.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Renal Replacement Therapy
Background:
- Prolonged intermittent renal replacement therapies (PIRRT) are increasingly utilized as a cost-effective alternative to continuous therapies in pediatric intensive care.
- Despite growing use, a consensus on PIRRT guidelines for pediatric patients remains absent.
Purpose of the Study:
- To develop evidence-based recommendations for the application of PIRRT in pediatric intensive care settings.
- To establish guidelines for the definition, indications, machine selection, and prescription of PIRRT in children.
Main Methods:
- A comprehensive literature search was conducted across PubMed/Medline, Embase, and Google Scholar.
- Medical librarians from India and Cleveland Clinic assisted in identifying relevant studies.
- The Pediatric Continuous Renal Replacement Therapy workgroup analyzed articles for relevance and graded evidence strength.
Main Results:
- Sixty studies were initially identified, with data from 37 studies used to formulate the guidelines.
- The developed guidelines cover key aspects of PIRRT, including its definition, indications, associated machinery, and prescription protocols.
- Recommendations were graded based on the strength of evidence.
Conclusions:
- The literature on PIRRT in pediatric populations is currently limited.
- Existing studies support the benefits of PIRRT in children.
- These expert recommendations represent a crucial initial step towards further research and standardized practice of PIRRT in pediatric critical care.
Introduction:
Recently, prolonged intermittent renal replacement therapies (PIRRT) have emerged as cost-effective alternatives to conventional CRRT and their use in the pediatric population has started to become more prominent. However, there is a lack of consensus guidelines on the use of PIRRT in pediatric patients in an intensive care setting.
Methods:
A literature search was performed on PubMed/Medline, Embase, and Google Scholar in conjunction with medical librarians from both India and the Cleveland Clinic hospital system to find relevant articles. The Pediatric Continuous Renal Replacement Therapy workgroup analyzed all articles for relevancy, proposed recommendations, and graded each recommendation for their strength of evidence.
Results:
Of the 60 studies eligible for review, the workgroup considered data from 37 studies to formulate guidelines for the use of PIRRT in children. The guidelines focused on the definition, indications, machines, and prescription of PIRRT.
Conclusion:
Although the literature on the use of PIRRT in children is limited, the current studies give credence to their benefits and these expert recommendations are a valuable first step in the continued study of PIRRT in the pediatric population.
Related Concept Videos
01:30Continuous Renal Replacement Therapy
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
01:20Acute Kidney Injury V: Interprofessional Care
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:28Chronic Kidney Disease III: Interprofessional Care
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations