Dialysis modalities for the management of pediatric acute kidney injury

Pediatr Nephrol. 2020 May;35(5):753-765. doi: 10.1007/s00467-019-04213-x. Epub 2019 Mar 18.

Abstract

Acute kidney injury (AKI) is an increasingly frequent complication among hospitalized children. It is associated with high morbidity and mortality, especially in neonates and children requiring dialysis. The different renal replacement therapy (RRT) options for AKI have expanded from peritoneal dialysis (PD) and intermittent hemodialysis (HD) to continuous RRT (CRRT) and hybrid modalities. Recent advances in the provision of RRT in children allow a higher standard of care for increasingly ill and young patients. In the absence of evidence indicating better survival with any dialysis method, the most appropriate dialysis choice for children with AKI is based on the patient's characteristics, on dialytic modality performance, and on the institutional resources and local practice. In this review, the available dialysis modalities for pediatric AKI will be discussed, focusing on indications, advantages, and limitations of each of them.

Keywords: AKI; CRRT; Children; Hemodialysis; Peritoneal dialysis; Regional citrate anticoagulation.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy*
  • Child
  • Clinical Decision-Making
  • Humans
  • Nephrology / methods
  • Nephrology / standards
  • Pediatrics / methods
  • Pediatrics / standards
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / instrumentation
  • Peritoneal Dialysis / methods*
  • Peritoneal Dialysis / standards
  • Practice Guidelines as Topic
  • Renal Dialysis / adverse effects
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Renal Dialysis / standards
  • Treatment Outcome