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A retrospective analysis: the outcome of renal replacement therapies in critically ill children

Kübra Çeleğen1, Mehmet Çeleğen2

  • 1Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology - Afyonkarahisar, Turkey.

Revista Da Associacao Medica Brasileira (1992)
|May 17, 2023
PubMed

Insights

Continuous renal replacement therapy (CRRT) was most utilized in critically ill children, but outcomes depend on disease severity and need for vasoactive drugs. Survival rates were 73% across all renal replacement therapies.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Intensive Care Unit Management

Background:

  • Limited pediatric studies exist on renal replacement therapy (RRT) for critically ill children.
  • Understanding RRT utilization and outcomes in pediatric intensive care is crucial.

Purpose of the Study:

  • To determine the utilization ratio of intermittent hemodialysis, continuous renal replacement therapy (CRRT), and peritoneal dialysis in critically ill children.
  • To analyze the characteristics and outcomes of pediatric patients undergoing RRT.

Main Methods:

  • A retrospective study included critically ill children who received RRT in the intensive care unit from February 2020 to May 2022.
  • Patients were categorized into three groups: hemodialysis, CRRT, and peritoneal dialysis.

Main Results:

  • Out of 37 pediatric patients, CRRT was used in 43%, hemodialysis in 38%, and peritoneal dialysis in 19%.
  • Overall survival was 73% (28/37), with 27% (9/37) mortality.
  • Lower systolic blood pressure was noted in the CRRT group (p<0.001). Higher PRISM III scores and need for inotropic medications were significant mortality predictors.

Conclusions:

  • Outcomes in critically ill children receiving RRT are influenced by disease severity and the requirement for vasoactive drugs.
  • CRRT group outcomes appear linked to the need for vasoactive drugs and underlying disease severity compared to other RRT modalities.
Abstract

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