ArticlePediatric nephrology (Berlin, Germany)2025
Experience of continuous kidney replacement therapy in a tertiary care unit of a lower-middle-income country.
Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Outcomes and mortality risk in children with acute kidney injury requiring dialysis and mechanical ventilation: an observational study from a pediatric nephrology critical care unit.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Continuous Kidney Replacement Therapy in Pediatric Intensive Care: A Practical Guide for Clinicians.Indian pediatrics · 2026Review
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7 authors.
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Abstract
backgroundInformation on the clinical characteristics and outcomes of children undergoing continuous kidney replacement therapy (CKRT) from lower-middle-income countries (LMIC) is limited.
methodsRecords of consecutive children 1 month to 18 years of age who underwent CKRT from Jan 2016 to Jan 2024 in a tertiary care pediatric intensive care unit (PICU) were retrospectively reviewed and analyzed for clinical and machine-related characteristics, and outcomes.
resultsOver the 8-year period, 102 patients (61.8% boys) with median age 4 (1.5-9) years underwent CKRT. Among these, 52 (51%) weighed < 15 kg, 37 (36.3%) were underweight, and 27 (26.5%) were stunted. Mean (SD) PRISM III score at admission was 17 (6.8), with 94.1% of patients ventilated and 90.2% on two or more inotropes at CKRT initiation. Septic shock (28.4%) and inborn errors of metabolism with acute decompensation (23.5%) were the most common diagnoses at PICU admission. Indications for CKRT were fluid overload, hyperammonemia or inborn errors of metabolism with acute decompensation, dyselectrolytemia, or their combination in 33.3%, 32.4%, 5.9%, and 19.6% patients, respectively. Continuous veno-venous hemodiafiltration (CVVHDF) was the most common (60.8%) modality employed, with an effluent dose of 32.8 ± 7.3 ml/kg/h. Despite heparin anticoagulation in 87.2% patients, circuit clot occurred in 28 patients, 18 (17.6%) of which led to termination of CKRT session. Overall mortality was 75%.
conclusionsCKRT can be safely performed in critically ill children from LMIC despite the presence of significant undernutrition and multi-organ dysfunction. Further studies from similar settings are required to evolve strategies to identify modifiable risk factors for the observed high mortality.
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