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Clinical features and risk factors associated with mortality in critically ill children requiring continuous renal

Muhterem Duyu1, Ceren Turkozkan2

  • 1Department of Pediatrics, Pediatric Intensive Care Unit, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|February 7, 2022
PubMed

Insights

This study identified key mortality risk factors in critically ill children receiving continuous renal replacement therapy (CRRT). Comorbidities, pneumonia, and high lactate levels independently predicted worse outcomes in the pediatric intensive care unit (PICU).

Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Intensive Care Medicine

Background:

  • Critically ill children often require advanced support like continuous renal replacement therapy (CRRT).
  • Understanding demographic factors and mortality predictors in this population is crucial for improving care.
  • Previous studies have varied in their findings regarding CRRT outcomes in pediatric intensive care units (PICUs).

Purpose of the Study:

  • To characterize the demographics of critically ill children undergoing CRRT in a PICU.
  • To identify independent risk factors associated with mortality in this patient group.

Main Methods:

  • Retrospective cohort study of 121 children receiving CRRT between May 2015 and May 2020.
  • Data collected from a tertiary healthcare institution's PICU.
  • Multivariate logistic regression analysis employed to determine independent predictors of mortality.

Main Results:

  • Overall mortality rate was 29.8%.
  • Shorter time to CRRT initiation was observed in sepsis survivors versus non-survivors (p=0.036).
  • Independent mortality predictors included comorbidity (OR: 5.71), pneumonia/respiratory failure (OR: 16.16), and high lactate at CRRT initiation (OR: 1.43).

Conclusions:

  • The observed mortality rate was lower than previously reported in similar pediatric populations.
  • Comorbidities, respiratory failure, and elevated lactate levels are significant risk factors for mortality in critically ill children on CRRT.
  • Study limitations include heterogeneous patient characteristics, potentially influencing subgroup analyses and survival outcomes.
Abstract

Keywords:
comorbiditycontinuous renal replacement therapycritically ill childrenlactatemortality

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