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Related Experiment Videos

Continuous veno-venous hemodiafiltration using bicarbonate dialysate

D Roy1, R J Hogg, P A Wilby

  • 1Department of Nephrology, Women's and Children's Hospital, North Adelaide, South Australia.

Pediatric Nephrology (Berlin, Germany)
|January 23, 1998
PubMed
Summary

Continuous veno-venous hemodiafiltration (CVVHDF) effectively treated 11 children, with 7 recovering normal kidney function. This pediatric renal replacement therapy demonstrated good control of metabolic acidosis.

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Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Replacement Therapy

Background:

  • Acute kidney injury (AKI) in children presents significant management challenges.
  • Pediatric patients often require specialized renal replacement therapy (RRT) for severe AKI and multi-organ failure.
  • Continuous veno-venous hemodiafiltration (CVVHDF) is an established RRT modality in critically ill adults, but its application in pediatrics requires careful consideration.

Purpose of the Study:

  • To report the clinical experience and outcomes of CVVHDF in a cohort of pediatric patients.
  • To evaluate the efficacy of CVVHDF in managing fluid balance, acid-base status, and uremic toxin clearance in children.
  • To assess the recovery of renal function following CVVHDF treatment in this pediatric population.

Main Methods:

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  • Retrospective analysis of 11 pediatric patients treated with CVVHDF.
  • Dual-lumen subclavian or femoral vein catheters were used for vascular access.
  • Hemofilters were selected based on patient size and dialysis needs, utilizing bicarbonate-buffered solutions.
  • Ultrafiltration rates, urea, and creatinine clearances were monitored.

Main Results:

  • The median age of the 11 pediatric patients was 5.0 years (range: 3 days to 14 years).
  • Mean ultrafiltration rate was 37.4 +/- 27 ml/kg/hr; urea and creatinine clearances were 15.1 +/- 6.4 ml/kg/min and 16.4 +/- 8.4 ml/kg/min, respectively.
  • Metabolic acidosis was effectively controlled in all patients, and 7 out of 11 patients recovered normal renal function.

Conclusions:

  • CVVHDF is a viable and effective treatment option for pediatric patients with acute kidney injury and fluid overload.
  • The modality allows for adequate clearance of uremic toxins and effective management of metabolic derangements in children.
  • A significant proportion of pediatric patients treated with CVVHDF can achieve recovery of renal function, highlighting its therapeutic potential.