Nonrenal indications for continuous renal replacement therapy

• DOI: 10.1097/pcc.0b013e31824fbd76
• Publication Date: 2012-08-15T08:56:47Z
• Authors: Geoffrey M. Fleming; Scott Walters; Stuart L. Goldstein; Steven R. Alexander; Michelle A. Baum; Douglas L. Blowey; Timothy E. Bunchman; Annabelle N. Chua; Sarah A. Fletcher; Francisco X. Flores; James D. Fortenberry; Richard Hackbarth; Kevin McBryde; Michael J. G. Somers; Jordan M. Symons; Patrick D. Brophy
• Keywords: Renal replacement therapy; Nephrology

Continuous renal replacement therapy is the most often implemented dialysis modality in pediatric intensive care unit setting for patients with acute kidney injury. However, it also has a role management of nonrenal indications such as clearance drugs and intermediates disordered cellular metabolism.Using data from multicenter Prospective Pediatric Renal Replacement Therapy Registry, we report cohort receiving continuous indications. Nonrenal were obtained combination "other" category initiation patient diagnosis (both primary secondary). This was further divided into three subgroups: inborn errors metabolism, drug toxicity, tumor lysis syndrome.From 2000 to 2005, total 50 events included Registry. Indication-specific survival subgroups 62% (inborn metabolism), 82% (tumor syndrome), 95% (drug toxicity). The median small solute dose delivered among ranged 2125 8213 mL/1.73 m/hr, 54%-59% solely diffusion-based venovenous hemodialysis. No association established between delivered, therapy, or use intermittent hemodialysis prior therapy.Pediatric requiring are distinct within population little published experience outcomes this group. Survival varies by indication not associated modality. Additionally, doses >2000 m/hr. Our suggest metabolic control rapidly that detoxification may be provided both initial maintenance phases treatment using either convection diffusion at appropriate doses.