When do children need kidney replacement therapy?

Abstract

Kidney replacement therapy (KRT) can provide lifesaving support for children with severely impaired kidney function. The decision about who needs KRT and when is often complex. Many acute kidney problems will resolve with conservative maanagemenent but some children with chronic or acute kidney impairment will find themselves in a position where KRT is required either as a bridge to recovery or kidney transplantation. Less commonly, children with metabolic disorders may find that the ability of their own kidneys is overwhelmed by excessive production of certain metabolites. These children may also benefit from short term KRT. This article aims to help paediatricians in training understand which children need kidney replacement therapy, the various types of treatment available, and when they are used.

Sustained Low Efficiency Dialysis in Critically Ill Children With Acute Kidney Injury: Single-Center Observational Cohort in a Resource-Limited Setting

“…Considering the resource and infrastructure limitations including lack of trained staff in CRRT and its high cost, SLED could be a feasible option of dialysis modality for critically ill unstable children in low- and middle-income countries like India (11, 12). Pediatric data on SLED are scarce.…”