J Korean Soc Pediatr Nephrol.  2011 Oct;15(2):107-115.

Overview of Pediatric Continuous Renal Replacement Therapy in Acute Kidney Injury

• Park SJ
• Shin JI

Abstract

Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

Keyword

Acute kidney injury; Continuous renal replacement therapy; Children

MeSH Terms

Acute Kidney Injury
Child
Critical Illness
Early Intervention (Education)
Humans
Hypotension
Critical Care
Intensive Care Units
Ischemia
Prescriptions
Prognosis
Renal Replacement Therapy
Sepsis