A Recent Experience About Pediatric Acute Dialysis in our Center

OBJECTIVE: Acute renal failure is a life-threatening event in critically ill children. The dialysis modality depends on the clinical status of the patient and technical opportunities. We aimed to assess the renal replacement therapies (RRT) performed in children admitted to our center in a four-year period.

MATERIAL and METHODS: We retrospectively evaluated the data of children who received RRT in intensive care units in our center between January 2004 and September 2007. The anthropometric values, etiological factors, dialysis details, laboratory fi ndings, medications, involvement of organs or systems other than kidneys and outcome of the patients were recorded.

RESULTS: There were 18 children (M/F:11/7) meeting the criteria aged between 3 days and 17 years. Seven of the patients were premature and three of them were very low-birth-weight infants Two patients received continuous hemodiafi ltration, two received intermittent hemodialysis and the rest of them received peritoneal dialysis. The most frequent cause for RRT was increased serum creatinine levels. The mean duration of care in ICU before RRT initiation was 6.67±5.01 (0-18) days. The mean duration of continuous RRT in patients except the two who received intermittent hemodialysis was 154.31±102.29 (40-396) hours. The mortality rate was 83% (15/18) and the three survivors received short-term peritoneal dialysis, one of whom additionally received intermittent hemodialysis due to vancomycin toxicity. Two of them needed no pressors. Each patient had complications associated with the type of dialysis modality and catheters, but none solely leaded to mortality. All three very low-birthweight infants received peritoneal dialysis via peripheral venous catheters.

CONCLUSIONS: Peritoneal dialysis is still an encouraging, simply performed RRT modality for acute renal failure, especially in small children. It is even accessible in very low-birth-weight infants through simple catheters. Sharing latest clinical experiences may encourage its use when other techniques are not available.