Pediatric continuous renal replacement therapy: have practice changes changed outcomes? A large single-center ten-year retrospective evaluation

Table 7 Comparative outcomes of present study with previously published pediatric CRRT studies; FO, fluid overload, EM electrolyte management

	Our Study	ppCRRT Registry ^{a, b}	Spain ^{c, d}	Birmingham ^e	Alberta (CRRT only) ^f
N	273	344	174	76	49
Weight
Mean/Median Wt (kg)	33.5	34.3		19.5(2.5–150)	19.5 (5.5–45)
Less than 10 kg (%)	23	24	43
10 to 20 kg (%)	25	20
20 to 50 kg (%)	25	29
> 50 kg (%)	27	27
Age
Mean / Median Age (yr)	8.4	8.5	4.3 (±5.3)	5.8 (0–17.8)	5.4 (0.3–13.8)
0 to 1 yr. (%)	21	20	43.7
1 to 3 yr. (%)	12	13
3 to 5 yr. (%)	8	8
5 to 10 yr. (%)	14	17
10 to 15 yr. (%)	21	19
15 to 21 yr. (%)	20	20
> 21 yr. (%)	4	3
Survival to discharge (%)	48	58	64	55	67
Principle diagnosis (%)
Sepsis	5	24	20	12
BMT	12	16		16
Cardiac	9	12	56	9
Renal	10	9	10	20
Liver	21	8		6
Malignancy	13	8		8
Ischemia/shock		6
Inborn error of metabolism	5	4	7
Drug intoxication		4	2
Tumor lysis syndrome		3	3	14
Pulmonary	5	3
Other	11	2	05	14
Survival on CRRT by Weight (N (%))
< 10 kg	28 (43%)	36 (43%)	57%
> 10 kg	105 (49%)	165 (63%)	73%
ICU days before CRRT	4 (1,10)	2			2 (1–5)
Days on CRRT	8 (4,16)				7 (3–18)
% FO	15 (8, 26)			12.9 (0–66.4)	20.1 (5.4–32.5)
Indication for CRRT & survival (%)
FO and EM	29 (41%)	15	32^g
FO	67 (45%)	18
EM	8(50%)	20	42^h
Prevent FO /provide nutrition	5(56%)	20
Other	24 (55%)	21

a. Symons JM, Chua AN, Somers MJ, et al. Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry. Clin J Am Soc Nephrol. July 2007;2(4):732–738
b. Sutherland SM, Zappitelli M, Alexander SR, et al. Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. Am J Kidney Dis. Feb 2010;55(2):316–25
c. Lopez-Herc J, Santiago MJ, Solana MJ et al. Clinical course of children requiring prolonged continuous renal replacement therapy. Pediatr Nephrol. Dec 2010; 25:523–528
d. Santiago MJ, Lopez-Herce J, Urbando J, et al. Clinical course and mortality risk factors in critically ill children requiring continuous renal replacement therapy. Intensive Care Med. May 2010;36(5):843–9
e. Hayes LW, Oster RA, Tofil NM, et al. Outcomes of critically ill children requiring continuous renal replacement therapy. J Crit Care. Sep 2009;24(3):394–400
f. Boschee E, Cave D, Garros D, et al. Indications and outcomes in children receiving renal replacement therapy in pediatric intensive care. J Crit Care. Feb 2014;29(1):37–42
g. Patients with diagnosis of AKI and hypervolemia
h. Patients with diagnosis of AKI

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