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Journal of the Korean Society of Pediatric Nephrology 2011;15(2): 107-115. doi: https://doi.org/10.3339/jkspn.2011.15.2.107
급성 신손상을 가진 소아의 지속적 신대체 요법
박세진, 신재일
1아주대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
Overview of Pediatric Continuous Renal Replacement Therapy in Acute Kidney Injury
Se-Jin Park, Jae-Il Shin
1Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital
2Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital
Received: September 7, 2011;  Accepted: September 26, 2011.
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ABSTRACT
Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.
Key words: Acute kidney injury | Continuous renal replacement therapy | Children
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