ArticlePediatric nephrology (Berlin, Germany)2016
Continuous renal replacement therapy in children: fluid overload does not always predict mortality.
Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- The Japanese clinical practice guideline for acute kidney injury 2016.Clinical and experimental nephrology · 2018Guideline
- Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA pediatrics · 2018Pooled it
- Specialized nursing improves clinical outcomes in pediatric AKI patients undergoing CRRT: a retrospective cohort study.American journal of translational research · 2026Article
- Outcomes of continuous kidney replacement therapy in pediatric patients: the impact of timing and predictors of mortality.Pediatric nephrology (Berlin, Germany) · 2025Article
- Experience of continuous kidney replacement therapy in a tertiary care unit of a lower-middle-income country.Pediatric nephrology (Berlin, Germany) · 2025Article
- Continuous Kidney Replacement Therapy and Survival in Children and Young Adults: Findings From the Multinational WE-ROCK Collaborative.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Article
- Fluid assessment, fluid balance, and fluid overload in sick children: a report from the Pediatric Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Time to Continuous Renal Replacement Therapy Initiation and 90-Day Major Adverse Kidney Events in Children and Young Adults.JAMA network open · 2024Article
- Prognostic Factors in Children with Acute Kidney Injury Requiring Continuous Renal Replacement Therapy.Blood purification · 2024Article
- Prospective Cohort Study on Cumulative Fluid Balance and Outcome in Critically Ill Children Using a Restrictive Fluid Protocol.Indian journal of pediatrics · 2022Article
- Patient-centered outcomes in pediatric continuous kidney replacement therapy: new morbidity and worsened functional status in survivors.Pediatric nephrology (Berlin, Germany) · 2022Article
- Association between early fluid overload and mortality in critically-ill mechanically ventilated children: a single-center retrospective cohort study.BMC pediatrics · 2021Article
- Dialysis modalities for the management of pediatric acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2020Review
- Epidemiology and Outcome of Critically Ill Pediatric Cancer and Hematopoietic Stem Cell Transplant Patients Requiring Continuous Renal Replacement Therapy: A Retrospective Nationwide Cohort Study.Critical care medicine · 2019Observational
- Pediatric continuous renal replacement therapy: have practice changes changed outcomes? A large single-center ten-year retrospective evaluation.BMC nephrology · 2018Article
- Fluid Overload in Critically Ill Children.Frontiers in pediatrics · 2018Review
- The Japanese Clinical Practice Guideline for acute kidney injury 2016.Journal of intensive care · 2018Article
- Update on pediatric sepsis: a review.Journal of intensive care · 2017Review
- Association of Fluid Accumulation with Clinical Outcomes in Critically Ill Children with Severe Sepsis.PloS one · 2016Article
- Fluid overload: clinical outcomes in pediatric intensive care unit.Jornal de pediatriaArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMortality among critically ill children requiring continuous renal replacement therapy (CRRT) is high. Several factors have been identified as outcome predictors. Many studies have specifically reported a positive association between the fluid overload at CRRT initiation and the mortality of critically ill pediatric patients.
methodsThis study is a retrospective single-center analysis including all patients admitted to the pediatric intensive care unit (PICU) of our hospital who received CRRT between 2000 and 2012. One hundred thirty-one patients were identified and subsequently classified according to primary disease. Survival rates, severity of illness and fluid balance differed among subgroups. The primary outcome was patient survival to PICU discharge.
resultsOverall survival to PICU discharge was 45.8 %. Based on multiple regression analysis, mortality was independently associated with onco-hematological disease [odds ratio (OR) 11.7, 95 % confidence interval (CI) 1.3-104.7; p = 0.028], severe multiple organ dysfunction syndrome (MODS) (OR 5.1, 95 % CI 1.7-15; p = 0.003) and hypotension (OR 11.6, 95 % CI 1.4-93.2; p = 0.021). In the subgroup analysis, a fluid overload (FO) of more than 10 % (FO>10 %) at the beginning of CRRT seems to be a negative predictor of mortality (OR 10.9, 95 % CI 0.78-152.62; p = 0.07) only in children with milder disease (renal patients). Due to lack of statistical power, the independent effect of fluid overload on mortality could not be analyzed in all subgroups of patients.
conclusionsIn children treated with CRRT the underlying diagnosis and severity of illness are independent risk factors for mortality. The degree of FO is a negative predictor only in patients with milder disease.
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