Definition: acute kidney injury (AKI) is failure of the kidneys to regulate electrolyte, acid-base and fluid homeostasis adequately with concomitant reduction in glomerular filtration rate (GFR). pRIFLE(paediatric Risk, Injury, Failure, Loss, End-Stage Criteria).
CVVHD (continuous venovenous haemodialysis – clearance via diffusion)
CVVH (continuous venovenous haemofiltration – clearance via convection)
CVVHDF (continuous venovenous haemodiafiltration – clearance via convection and diffusion), most commonly done, PD (peritoneal Dialysis), SCUF, IHD (intermittent haemodialysis).
Comparison of Renal Replacement Therapy
Variable
PD
CRRT
IHD
Convection
+
+++
Diffusion
++
++
Fluid control
–
++
++
Uraemia control
–
++
+
Vascular access
Tenkhoff
required
required
Anitcoagulation
not applicable
required
required
References:
[1] Kidney International 71, 2007, 1028 – 1035, Akcan-Arikan et al: Modified RIFLE criteria in critically ill children with acute kidney injuryAKI in critically ill children
[2] Am J Kidney Dis. 2005, Jan;45(1):96-101: Hui-Stickle et al: Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001
[3] Adv Chronic Kidney Dis, 2008 July ; 15(3): 278-283: Goldstein et al: PROGRESSION FROM ACUTE KIDNEY INJURY TO CHRONIC KIDNEY DISEASE: A PEDIATRIC PERSPECTIVE: An invited review for Advances in Chronic Kidney Disease
[4] Pediatr Nephrol, 2009, 24: 37-49: Walters et al: Dialysis and pediatric acute kidney injury: choice of renal support modality
[5] Pediatr Nephrol. 2005 Jul;20(7):972-6: McNiece et al: Adequacy of peritoneal dialysis in children following cardiopulmonary bypass surgery
[6] Schrier: www.kidneyatlas.org
All Marc’s PICU cardiology FOAM can be found on PICU Doctor and can be downloaded as a handy app for free on iPhone or Android. A list of contributors can be seen here.
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Renal Failure
Tags: arf, crf, renal failure
Marc Anders. Renal Failure, Don't Forget the Bubbles, 2013. Available at:
https://doi.org/10.31440/DFTB.3719
Definition: acute kidney injury (AKI) is failure of the kidneys to regulate electrolyte, acid-base and fluid homeostasis adequately with concomitant reduction in glomerular filtration rate (GFR). pRIFLE (paediatric Risk, Injury, Failure, Loss, End-Stage Criteria).
Chronic renal failure: hyperfiltration, estimated creatinine clearance <75 ml/min/1.73m2 , hypertension, microalbuminuria.
Causes:
Multi-organ failure, congenital heart surgery, nephrotoxic substances, stem-cell transplantation, sepsis, HUS.
Causes:
AKI, dysplasia, renal reflux, obstructive nephropathy, chronic GN.
Options for renal replacement therapy (RRT):
CVVHD (continuous venovenous haemodialysis – clearance via diffusion)
CVVH (continuous venovenous haemofiltration – clearance via convection)
CVVHDF (continuous venovenous haemodiafiltration – clearance via convection and diffusion), most commonly done, PD (peritoneal Dialysis), SCUF, IHD (intermittent haemodialysis).
References:
[1] Kidney International 71, 2007, 1028 – 1035, Akcan-Arikan et al: Modified RIFLE criteria in critically ill children with acute kidney injuryAKI in critically ill children [2] Am J Kidney Dis. 2005, Jan;45(1):96-101: Hui-Stickle et al: Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001 [3] Adv Chronic Kidney Dis, 2008 July ; 15(3): 278-283: Goldstein et al: PROGRESSION FROM ACUTE KIDNEY INJURY TO CHRONIC KIDNEY DISEASE: A PEDIATRIC PERSPECTIVE: An invited review for Advances in Chronic Kidney Disease [4] Pediatr Nephrol, 2009, 24: 37-49: Walters et al: Dialysis and pediatric acute kidney injury: choice of renal support modality [5] Pediatr Nephrol. 2005 Jul;20(7):972-6: McNiece et al: Adequacy of peritoneal dialysis in children following cardiopulmonary bypass surgery [6] Schrier: www.kidneyatlas.orgAll Marc’s PICU cardiology FOAM can be found on PICU Doctor and can be downloaded as a handy app for free on iPhone or Android. A list of contributors can be seen here.
About Marc Anders
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