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Infant Renal Replacement Therapy Using Carpediem: A Multicenter Observational Cohort Study from the ICONIIC Learning

Cara L Slagle1, Kim T Vuong2, Kelli A Krallman3

  • 1Division of Neonatology, Riley Hospital for Children at Indiana University Health and Indiana University College of Medicine, Indianapolis, IN; Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine, Cincinnati, OH; Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

The Journal of Pediatrics
|September 28, 2025
PubMed

Insights

Survival for infants receiving continuous renal replacement therapy (CRRT) with the Carpediem system exceeded 60% in a US study. The primary use of CRRT was for end-stage kidney disease (ESKD) in infants.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Medical Devices

Background:

  • Continuous renal replacement therapy (CRRT) is crucial for critically ill infants with kidney dysfunction.
  • The Carpediem system is the first infant-specific CRRT platform approved in the US.
  • Evaluating its real-world use and outcomes is essential for optimizing pediatric critical care.

Purpose of the Study:

  • To assess the indications for using the Carpediem system in infants.
  • To evaluate the clinical outcomes, including survival, associated with Carpediem use.
  • To analyze CRRT treatment courses and patient characteristics in a US cohort.

Main Methods:

  • A multicenter observational study (retrospective and prospective) was conducted across four US centers.
  • Data were collected on infants undergoing CRRT using the Carpediem system.
  • Infant cohorts were categorized by CRRT indication: end-stage kidney disease (ESKD) and non-ESKD.

Main Results:

  • Sixty-seven infants underwent 93 treatment courses with the Carpediem system.
  • The primary indication for CRRT was ESKD (54%), followed by acute kidney injury (43%).
  • Hospital discharge survival was 67% for ESKD and 60% for non-ESKD infants.

Conclusions:

  • Carpediem facilitates CRRT in infants, with survival rates exceeding 60% in this US cohort.
  • ESKD as a bridge to dialysis was the most common indication for CRRT in this population.
  • The findings support the utility of Carpediem in managing critically ill infants requiring renal support.
Abstract

Keywords:
CarpediemICONIICacute kidney injurycongenital kidney failurecontinuous kidney replacement therapyend-stage kidney diseasefluid overloadinfantneonatalpediatric

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