Long-term kidney outcomes in children following continuous kidney replacement therapy

Frisby-Zedan, Jeanne; Barhight, Matthew; Keswani, Mahima; Arzu, Jennifer; Nelson, Delphine

doi:10.1007/s00467-022-05579-1

Cited by 5 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After 30 days, the renal recovery rate decreased drastically and less than 40% of the patients achieved renal recovery by 90 days. The median follow-up of critically ill pediatric patients with AKI-D has ranged from 2.5 to 9.6 y (12, 13). These studies focused on CKD and long-term mortality, and not on the changes in patients’ renal function after the acute insult.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy

Thadani,

Fuhrman,

Hanson

et al. 2024

Critical Care Explorations

View full text Add to dashboard Cite

OBJECTIVES: Acute kidney injury requiring dialysis (AKI-D) commonly occurs in the setting of multiple organ dysfunction syndrome (MODS). Continuous renal replacement therapy (CRRT) is the modality of choice for AKI-D. Mid-term outcomes of pediatric AKI-D supported with CRRT are unknown. We aimed to describe the pattern and impact of organ dysfunction on renal outcomes in critically ill children and young adults with AKI-D. DESIGN: Retrospective cohort. SETTING: Two large quarternary care pediatric hospitals. PATIENTS: Patients 26 y old or younger who received CRRT from 2014 to 2020, excluding patients with chronic kidney disease. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Organ dysfunction was assessed using the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score. MODS was defined as greater than or equal to two organ dysfunctions. The primary outcome was major adverse kidney events at 30 days (MAKE30) (decrease in estimated glomerular filtration rate greater than or equal to 25% from baseline, need for renal replacement therapy, and death). Three hundred seventy-three patients, 50% female, with a median age of 84 mo (interquartile range [IQR] 16–172) were analyzed. PELOD-2 increased from 6 (IQR 3–9) to 9 (IQR 7–12) between ICU admission and CRRT initiation. Ninety-seven percent of patients developed MODS at CRRT start and 266 patients (71%) had MAKE30. Acute kidney injury (adjusted odds ratio [aOR] 3.55 [IQR 2.13–5.90]), neurologic (aOR 2.07 [IQR 1.15–3.74]), hematologic/oncologic dysfunction (aOR 2.27 [IQR 1.32–3.91]) at CRRT start, and progressive MODS (aOR 1.11 [IQR 1.03–1.19]) were independently associated with MAKE30. CONCLUSIONS: Ninety percent of critically ill children and young adults with AKI-D develop MODS by the start of CRRT. Lack of renal recovery is associated with specific extrarenal organ dysfunction and progressive multiple organ dysfunction. Currently available extrarenal organ support strategies, such as therapeutic plasma exchange lung-protective ventilation, and other modifiable risk factors, should be incorporated into clinical trial design when investigating renal recovery.

show abstract

Section: Discussionmentioning

confidence: 99%

Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy

Thadani,

Fuhrman,

Hanson

et al. 2024

Critical Care Explorations

View full text Add to dashboard Cite

show abstract

“…Ten were published by a student with a faculty appointment [34][35][36][37][38][39][40][41][42][43]. Overall, there were 3 case reports [34,44,45], one case series [46], 2 editorials [41,43], 2 letters [37,47], 2 review articles [48,49], 7 systematic reviews [35,36,[38][39][40]42,50], 2 retrospective cohort studies [51,52], an evaluation of mobile health applications [53], and a medical education report. [54] One case report noted the subject's race, without further comment [44].…”

Section: Course Evaluation and Student Publicationsmentioning

confidence: 99%

Anti-racist strategies for clinical and translational research: Design, implementation, and lessons learned from a new course

Heard-Garris

Brown

Ewulonu

et al. 2022

J. Clin. Trans. Sci.

View full text Add to dashboard Cite

show abstract

Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study

Menon,

Starr,

Zang

et al. 2024

Pediatr Nephrol

View full text Add to dashboard Cite

Long-term kidney outcomes in children following continuous kidney replacement therapy

Cited by 5 publications

References 18 publications

Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy

Patterns of Multiple Organ Dysfunction and Renal Recovery in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy

Anti-racist strategies for clinical and translational research: Design, implementation, and lessons learned from a new course

Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study

Contact Info

Product

Resources

About