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Pediatric continuous kidney replacement therapy: The Indonesian experience
Henny Adriani Puspitasari1, Eka Laksmi Hidayati2, Reza Fahlevi2
1Department of Child Health, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. henny.adriani01@ui.ac.id.
Pediatric Nephrology (Berlin, Germany)
|May 22, 2025
Summary
Continuous kidney replacement therapy (CKRT) is vital for critically ill children with acute kidney injury (AKI). Resource limitations significantly impacted CKRT outcomes in this study, resulting in a low survival rate.
Area of Science:
- Pediatric Critical Care Medicine
- Nephrology
- Renal Replacement Therapy
Background:
- Acute kidney injury (AKI) is a frequent complication in critically ill children.
- Continuous kidney replacement therapy (CKRT) is the primary treatment, especially for hemodynamically unstable patients.
- Data on CKRT in resource-constrained settings are limited, yet crucial for improving outcomes.
Purpose of the Study:
- To analyze the characteristics of critically ill children undergoing CKRT in a resource-limited setting.
- To identify factors influencing CKRT outcomes in this population.
- To provide insights into CKRT management in challenging environments.
Main Methods:
- Retrospective analysis of medical records from January 2015 to June 2023.
- Collected demographic, clinical, and laboratory data.
- Compared data between survivors and non-survivors.
Main Results:
- Fifty-six children received CKRT, with sepsis-associated AKI being the main indication.
- The overall survival rate was 25%.
- Demographics and CKRT prescriptions were similar to other centers, but resource limitations likely contributed to poor outcomes.
Conclusions:
- Despite challenges, CKRT is essential for critically ill children with AKI.
- Resource limitations significantly hinder CKRT effectiveness and survival rates.
- Further research and resource allocation are needed to improve pediatric CKRT in underserved areas.
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