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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
Summary
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.
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