Choice of dialysis modality for management of pediatric acute renal failure

Flynn, Joseph T.

doi:10.1007/s004670200011

Cited by 108 publications

(50 citation statements)

References 59 publications

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“…37 Alkan et al and Flynn reported that Peritoneal dialysis remains an effective modality for the management of pediatric AKI. 38,39 Complications of PD include bladder and bowel perforation, along with bleeding issues related to the procedure. 8 Peritonitis was not seen in our patients.…”

Section: Discussionmentioning

confidence: 99%

Diabetic ketoacidosis with acute kidney injury in prepubertal children: a report on two cases

Andriyani¹,

Wahyudhi²,

Anggriawan³

2017

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Type 1 diabetes mellitus is a result of autoimmune damage, in which environmental factors are thought to trigger the autoimmune destruction of pancreatic ß-cells.1,2 Worldwide, an estimated 65,000 children under 15 years of age develop type 1 diabetes mellitus each year.3 Approximately 30% of children who present with newly-diagnosed type 1 diabetes have diabetic ketoacidosis (DKA).4 Himawan et al. reported a DKA prevalence of43.6% in girls.5 The long-term effects of diabetes mellitus include retinopathy, chronic kidney disease (nephropathy), neuropathy, and dyslipidemia.2

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Section: Discussionmentioning

confidence: 99%

Diabetic ketoacidosis with acute kidney injury in prepubertal children: a report on two cases

Andriyani¹,

Wahyudhi²,

Anggriawan³

2017

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“…The choice of dialysis modality to be used is influenced by several factors, including the goals of the dialysis, the unique advantages and disadvantages of each modality, and institutional resources. Intermittent dialysis may not be well tolerated in infants because of rapid rate of fluid removal and of osmotic shifts secondary to sudden solute clearance: this condition is particularly evident in hemodynamically unstable, critically ill pediatric patients [18]. A specific indication to intermittent dialysis is the presence of severe hyperammonemia refractory to medical therapy [19].…”

Section: The Modern Practice Of Crrt In Infantsmentioning

confidence: 99%

CA.R.PE.DI.E.M. (Cardio–Renal Pediatric Dialysis Emergency Machine): evolution of continuous renal replacement therapies in infants. A personal journey

2012

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Pedriatric acute kidney injury (AKI) is a welldescribed clinical syndrome that is characterized by a reduction of both the urine output and glomerular filtration rate. AKI in critically ill children is typically associated with multiple organ dysfunction. A dramatic increase in the incidence of AKI in pediatric intensive care units has been observed in the last 10 years. Unfortunately, the absence of sufficiently effective preventive and therapeutic measures at the present time has limited significant improvements in AKI care. Morality in patients with severe AKI remains unacceptably high (>50 %), with renal replacement therapy (RRT) remaining the most effective form of support for these patients. Despite technological advances during the last 10 years which have resulted in the development of the so-called "third-generation dialysis machines" that are characterized by the highest level of safety and accuracy, a truly pedriatric RRT system has never been developed. Consequently, dialysis/hemofiltration in critically ill children is currently performed by adapting adult systems to the much smaller pediatric patients. In particular, research in this field should focus on children weighing less than 10 kg for whom the delivery of RRT is a clinical and technological challenge. We describe here the evolution of pediatric RRT during the last 30 years and report in detail on the CARPE-DIEM project, which has recently been established to finally provide neonates and infants with a reliable dialysis machine that is specifically designed for this age group.

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“…[1][2][3] Srinivasan et al 4 found that blood glucose level >150 mg/dL was associated with a 3.5-fold increased risk of mortality. In critically ill adults, a large prospective randomized clinical study showed that strict control of blood glucose with insulin therapy reduced the incidence of acute kidney injury (AKI).…”

Section: Introductionmentioning

confidence: 99%

“…AKI in children is associated with significant mortality, as high as 60%. 3 Therefore, prevention of AKI is crucial, and includes hemodynamic support, maintenance of euvolemia, and avoidance of nephrotoxic medications. However, it…”

Section: Introductionmentioning

confidence: 99%

Hyperglycemia and acute kidney injury in critically ill children

Gordillo¹,

Ahluwalia²,

Woroniecki³

2016

IJNRD

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and hypertension, stony Brook children's hospital, stony Brook, NY, Usa Background: Hyperglycemia and acute kidney injury (AKI) are common in critically ill children and have been associated with higher morbidity and mortality. The incidence of AKI in children is difficult to estimate because of the lack of a standard definition for AKI. The pediatric RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) criteria can be used to define AKI in children. Various biomarkers in urine and blood have been studied to detect AKI in critically ill children. However, it is not clear whether hyperglycemia is associated with AKI. Our objective was to evaluate the effect of hyperglycemia on kidney function and its effect on neutrophil gelatinase-associated lipocalin (NGAL) in children. Methods: We studied retrospective and prospective cohorts of pediatric critically ill subjects admitted to the pediatric intensive care unit (PICU). We analyzed data from admission that included estimated glomerular filtration rate, plasma and urine NGAL, serum glucose and peak glycemia (highest glycemia during PICU admission), and length of hospital and PICU stay from two different institutions. Results: We found that the prevalence of hyperglycemia was 89% in the retrospective cohort and 86% in the prospective cohort, P=0.99. AKI was associated with peak glycemia, P=0.03. There was a statistically significant correlation between peak glycemia and hospital and PICU stays, P=<0.001 and P<0.001, respectively. Urine NGAL and plasma NGAL were not statistically different in subjects with and without hyperglycemia, P=0.99 and P=0.85, respectively. Subjects on vasopressors had lower estimated glomerular filtration rate and higher glycemia, P=0.01 and P=0.04, respectively. Conclusion: We conclude that in critically ill children, hyperglycemia is associated with AKI and longer PICU stays.

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Choice of dialysis modality for management of pediatric acute renal failure

Cited by 108 publications

References 59 publications

Diabetic ketoacidosis with acute kidney injury in prepubertal children: a report on two cases

Diabetic ketoacidosis with acute kidney injury in prepubertal children: a report on two cases

CA.R.PE.DI.E.M. (Cardio–Renal Pediatric Dialysis Emergency Machine): evolution of continuous renal replacement therapies in infants. A personal journey

Hyperglycemia and acute kidney injury in critically ill children

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