Advances in Pediatric Renal Replacement Therapy for Acute Kidney Injury

Authors

  • Stuart L. Goldstein

    1. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
    2. Division of Nephrology and Hypertension, Center for Acute Care Nephrology, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Address correspondence to: Stuart L. Goldstein, MD, Division of Nephrology and Hypertension, Center for Acute Care Nephrology, The Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7022, Cincinnati, OH 45229-3039, USA, Tel.: 513 636 2209, Fax: 513 636 7407, or e-mail: stuart.goldstein@cchmc.org.

Abstract

The disease spectrum leading to pediatric renal replacement therapy (RRT) provision has broadened over the last decade. In the 1980s, intrinsic renal disease and burns comprised the most common pediatric acute renal failure etiologies; more recent data demonstrate that pediatric acute kidney injury (AKI) most often results from complications of other systemic diseases resulting from the advancements in congenital heart surgery, neonatal care, and bone marrow and solid organ transplantation. In addition, RRT modality preferences to treat critically ill children have shifted from peritoneal dialysis to continuous renal replacement therapy (CRRT) as a result of improvements in CRRT technologies. In this article, we aim to review the pediatric specific causes for RRT provision, emphasizing the emerging practice patterns with respect to modality and timing of treatment. We will focus on the application of different RRT modalities and related outcome of children with AKI who receive RRT.

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