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Continuous Kidney Replacement Therapy in Pediatric Intensive Care: A Practical Guide for Clinicians.

Deblina Dasgupta1, Rajiv Sinha2, Akash Deep3

  • 1Division of Pediatric Nephrology, Institute of Child Health, Kolkata, West Bengal, India.

Indian Pediatrics
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Summary

Acute kidney injury (AKI) is rising in pediatric intensive care units (PICUs), increasing the need for kidney replacement therapy (KRT). Continuous kidney replacement therapy (CKRT) is a vital treatment option for critically ill children in PICUs.

Keywords:
Acute kidney injuryCritically ill childrenRenal replacement therapy

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Area of Science:

  • Pediatric Intensive Care Medicine
  • Nephrology
  • Critical Care

Background:

  • Increasing complexity of pediatric intensive care unit (PICU) admissions correlates with a rise in acute kidney injury (AKI).
  • Standard extracorporeal therapies like hemodialysis are often impractical for critically ill children requiring kidney replacement therapy (KRT).

Purpose of the Study:

  • To provide a concise guide on the practical aspects of continuous kidney replacement therapy (CKRT).
  • To support postgraduate trainees and intensivists managing pediatric patients with AKI in the PICU.

Main Methods:

  • This article is a review summarizing practical considerations for CKRT.
  • Focuses on the application and management of CKRT in the PICU setting.

Main Results:

  • Continuous kidney replacement therapy (CKRT) is the preferred KRT modality in high-income countries' PICUs.
  • CKRT utilization is growing in emerging economies, such as India, due to its benefits for critically ill children.

Conclusions:

  • CKRT is an essential and increasingly utilized therapy for pediatric acute kidney injury in intensive care settings.
  • This review offers practical insights for effective CKRT implementation and management in PICUs.