Acute Renal Replacement Therapy in Pediatrics
Acute kidney injury (AKI) independently increases morbidity and mortality in children admitted to the hospital. Renal replacement therapy (RRT) is an essential therapy in the setting of AKI and fluid overload. The decision to initiate RRT is complex and often complicated by concerns related to patie...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.4061/2011/785392 |
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| author | Rajit K. Basu Derek S. Wheeler Stuart Goldstein Lesley Doughty |
| author_facet | Rajit K. Basu Derek S. Wheeler Stuart Goldstein Lesley Doughty |
| author_sort | Rajit K. Basu |
| collection | DOAJ |
| description | Acute kidney injury (AKI) independently increases morbidity and mortality in children admitted to the hospital. Renal replacement therapy (RRT) is an essential therapy in the setting of AKI and fluid overload. The decision to initiate RRT is complex and often complicated by concerns related to patient hemodynamic and thermodynamic instability. The choice of which RRT modality to use depends on numerous criteria that are both patient and treatment center specific. Surprisingly, despite decades of use, no randomized, controlled trial study involving RRT in pediatrics has been performed. Because of these factors, clear-cut consensus is lacking regarding key questions surrounding RRT delivery. In this paper, we will summarize existing data concerning RRT use in children. We discuss the major modalities and the data-driven specifics of each, followed by controversies in RRT. As no standard of care is in widespread use for RRT in AKI or in multiorgan disease, we conclude in this paper that prospective studies of RRT are needed to identify best practice guidelines. |
| format | Article |
| id | doaj-art-2c9edacf00b54707ab7e3d10b69ce17e |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-2c9edacf00b54707ab7e3d10b69ce17e2025-02-03T01:26:17ZengWileyInternational Journal of Nephrology2090-214X2090-21582011-01-01201110.4061/2011/785392785392Acute Renal Replacement Therapy in PediatricsRajit K. Basu0Derek S. Wheeler1Stuart Goldstein2Lesley Doughty3Division of Critical Care and Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USADivision of Critical Care and Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USADepartment of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USADivision of Critical Care and Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USAAcute kidney injury (AKI) independently increases morbidity and mortality in children admitted to the hospital. Renal replacement therapy (RRT) is an essential therapy in the setting of AKI and fluid overload. The decision to initiate RRT is complex and often complicated by concerns related to patient hemodynamic and thermodynamic instability. The choice of which RRT modality to use depends on numerous criteria that are both patient and treatment center specific. Surprisingly, despite decades of use, no randomized, controlled trial study involving RRT in pediatrics has been performed. Because of these factors, clear-cut consensus is lacking regarding key questions surrounding RRT delivery. In this paper, we will summarize existing data concerning RRT use in children. We discuss the major modalities and the data-driven specifics of each, followed by controversies in RRT. As no standard of care is in widespread use for RRT in AKI or in multiorgan disease, we conclude in this paper that prospective studies of RRT are needed to identify best practice guidelines.http://dx.doi.org/10.4061/2011/785392 |
| spellingShingle | Rajit K. Basu Derek S. Wheeler Stuart Goldstein Lesley Doughty Acute Renal Replacement Therapy in Pediatrics International Journal of Nephrology |
| title | Acute Renal Replacement Therapy in Pediatrics |
| title_full | Acute Renal Replacement Therapy in Pediatrics |
| title_fullStr | Acute Renal Replacement Therapy in Pediatrics |
| title_full_unstemmed | Acute Renal Replacement Therapy in Pediatrics |
| title_short | Acute Renal Replacement Therapy in Pediatrics |
| title_sort | acute renal replacement therapy in pediatrics |
| url | http://dx.doi.org/10.4061/2011/785392 |
| work_keys_str_mv | AT rajitkbasu acuterenalreplacementtherapyinpediatrics AT derekswheeler acuterenalreplacementtherapyinpediatrics AT stuartgoldstein acuterenalreplacementtherapyinpediatrics AT lesleydoughty acuterenalreplacementtherapyinpediatrics |