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Efficacy of Kidney Support Therapy in Critically Sick Children with Acute Kidney Injury: A Cross-Sectional Study

Bijay Kumar Meher1, Vivek Mahapatra2, Aishwarya Chandra1

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, Sardar Vallabhbhai Patel Postgraduate Institute of Pediatrics, Sriram Chandra Bhanja Medical College, Cuttack, Odisha, India.

Indian Pediatrics
|February 11, 2026
PubMed

Insights

Continuous renal replacement therapy (CRRT) showed better outcomes for critically ill children with acute kidney injury (AKI) compared to peritoneal dialysis (PD). Higher PRISM III scores and lower eGFR predicted mortality in these patients.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Replacement Therapy

Background:

  • Acute kidney injury (AKI) is a critical condition in children, requiring Kidney Support Therapy (KST) to manage metabolic issues and improve survival.
  • The comparative effectiveness of different KST methods, including peritoneal dialysis (PD), hemodialysis (HD), and continuous renal replacement therapy (CRRT), is not well-established.

Purpose of the Study:

  • To compare the effectiveness of different KST modalities in critically ill children with AKI.
  • To identify predictors of mortality in pediatric AKI patients undergoing KST.

Main Methods:

  • A cross-sectional analytical study was conducted in a tertiary care center.
  • Included were pediatric patients undergoing PD (n=16), HD (n=17), or CRRT (n=20).
  • Evaluated outcomes included urea and creatinine reduction ratios and survival rates.

Main Results:

  • CRRT demonstrated higher urea and creatinine reduction ratios compared to PD.
  • Survival rates were also higher in the CRRT group versus the PD group.
  • Elevated PRISM III scores and decreased estimated glomerular filtration rate (eGFR) were identified as significant predictors of mortality.

Conclusions:

  • CRRT appears to be more effective than PD in improving biochemical markers and survival in critically ill children with AKI.
  • PRISM III scores and eGFR are crucial indicators for assessing mortality risk in this patient population.

Keywords:
Acute kidney injuryChildCritical illnessKidney support therapy

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