Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Renal replacement therapy in children with acute renal failure

소아 급성 신부전증의 신장 대체 요법

  • Paik, Kyung Hoon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 백경훈 (성균관대학교 의과대학 소아과학교실)
  • Received : 2007.08.16
  • Accepted : 2007.09.05
  • Published : 2007.10.15
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Abstract

Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

Keywords

References

  1. Moghal NE, Brocklebank JT, Meadow SR. A review of acute renal failure in children: incidence, etiology and outcome. Clin Nephrol 1998;49:91-5
  2. Chadha V, Srivastava T. Management of acute renal failure with hemodialysis and peritoneal dialysis. In: Warady BA, Schaefer FS, Fine RN, Alexander SR, editors. Pediatric Dialysis. Great Britain: Kluwer Academic Publishers 2004:595-618
  3. Donckerwolcke RA, Bunchman TE. Hemodialysis in infants and small children. Pediatr Nephrol 1994;8:103-6 https://doi.org/10.1007/BF00868283
  4. Parekh RS, Bunchman TE. Dialysis support in the pediatric intensive care unit. Adv Ren Replace Ther 1996;3:326-36 https://doi.org/10.1016/S1073-4449(96)80013-6
  5. Kiessling SG, Somers MJG. Hemodialysis in children. In: Nissenson AR, Fine RN, editors. Clinical Dialysis. 4th ed. New York McGraw-Hill 2005:293-307
  6. Warady BA. Optimizing dialysis in pediatric patients. In: Nissenson AR, Fine RN, editors. Clinical Dialysis. 4th ed. New York McGraw-Hill 2005:203-22
  7. Goldstein SL, Jabs K. Hemodialysis. In: Avener ED, Harmon WE, Niaudet P, editors. Pediatric Nephrology. 5th ed. Philadelphia: Lippincott Williams & Wilkins 2004:1395-410
  8. Geary DF, Gajaria M, Fryer-Keene S, Willumsen J. Lowdose and heparin-free hemodialysis in children. Pediatr Nephrol 1991;5:220-4 https://doi.org/10.1007/BF01095957
  9. Flynn JT, Kershaw DB, Smoyer WE, Brophy PD, McBryde KD, Bunchman TE. Peritoneal dialysis for management of pediatric acute renal failure. Perit Dial Int 2001;21:390-4
  10. Sojo E, Bisigniano L, Turconi A, Falke G, Grosman M, Delgado N, et al. Is fibrin glue useful in preventing dialysate leakage in children on CAPD? Preliminary results of a prospective randomized study. Adv Perit Dial 1997;13:277-80
  11. Jeong SI, Lee HY, Lee CG, Seo JM, Lee SK, Kim SJ, et al. Comparison of Early Complications after Peritoneal Dialysis Catheter Implantation by Laparoscopic Surgery and Conventional Surgery in Children. J Korean Soc Pediatr Nephrol 2007;11:51-8 https://doi.org/10.3339/jkspn.2007.11.1.51
  12. Lorentz WB, Jr. Acute hydrothorax during peritoneal dialysis. J Pediatr 1979;94:417-9 https://doi.org/10.1016/S0022-3476(79)80587-9
  13. Bunchman TE, Meldrum MK, Meliones JE, Sedman AB, Walters MB, Kershaw DB. Pulmonary function variation in ventilator dependent critically ill infants on peritoneal dialysis. Adv Perit Dial 1992;8:75-8
  14. Katz A, Kashtan CE, Greenberg LJ, Shapiro RS, Nevins TE, Kim Y. Hypogammaglobulinemia in uremic infants receiving peritoneal dialysis. J Pediatr 1990;117:258-61 https://doi.org/10.1016/S0022-3476(05)80541-4
  15. Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 2000;356:26-30 https://doi.org/10.1016/S0140-6736(00)02430-2
  16. Werner HA, Herbertson MJ, Seear MD. Functional characteristics of pediatric veno-venous hemofiltration. Crit Care Med 1994;22:320-5 https://doi.org/10.1097/00003246-199402000-00025
  17. Gregory M, Bunchman TE, Brophy PD. Continuous renal replacement therapies for children with acute renal failure and metabolic renal disorders. In: Warady BA, Schaefer FS, Fine RN, Alexander SR, editors. Pediatric Dialysis 2004:567-84
  18. Bunchman TE, McBryde KD, Mottes TE, Gardner JJ, Max- voId NJ, Brophy PD. Pediatric acute renal failure: outcome by modality and disease. Pediatr Nephrol 2001;16:1067-71 https://doi.org/10.1007/s004670100029
  19. Lai WM. Renal replcement therapy in acute renal failure: acute dialysis and continuous renal replacement therapy. In: Chiu MC, Yap HK, editors. Practical Paediatric Nephrology 2005:234-46
  20. Bunchman TE, Maxvold NJ, Barnett J, Hutchings A, Benfield MR. Pediatric hemofiltration: Normocarb dialysate solution with citrate anticoagulation. Pediatr Nephrol 2002;17: 150-4 https://doi.org/10.1007/s00467-001-0791-0
  21. Tolwani AJ, Campbell RC, Schenk MB, Allon M, Warnock DG. Simplified citrate anticoagulation for continuous renal replacement therapy. Kidney Int 2001;60:370-4 https://doi.org/10.1046/j.1523-1755.2001.00809.x
  22. Hahn H, Park YS. Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy in Children. J Korean Soc Pediatr Nephrol 2005;9:76-82
  23. Cointault O, Kamar N, Bories P, Lavayssiere L, Angles O, Rostaing L, et al. Regional citrate anticoagulation in continuous venovenous haemodiafiltration using commercial solutions. Nephrol Dial Transplant 2004;19:171-8 https://doi.org/10.1093/ndt/gfg488
  24. Gupta M, Wadhwa NK, Bukovsky R. Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate. Am J Kidney Dis 2004;43:67-73 https://doi.org/10.1053/j.ajkd.2003.09.014