title: Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry.
abstract: BACKGROUND
  This article reports demographic characteristics and intensive care unit survival for 344 patients from the Prospective Pediatric Continuous Renal Replacement Therapy (ppCRRT) Registry, a voluntary multicenter observational network.
  
  
  METHODS
  Ages were newborn to 25 yr, 58% were male, and weights were 1.3 to 160 kg. Patients spent a median of 2 d in the intensive care unit before CRRT (range 0 to 135). At CRRT initiation, 48% received diuretics and 66% received vasoactive drugs. Mean blood flow was 97.9 ml/min (range 10 to 350 ml/min; median 100 ml/min); mean blood flow per body weight was 5 ml/min per kg (range 0.6 to 53.6 ml/min per kg; median 4.1 ml/min per kg). Days on CRRT were <1 to 83 (mean 9.1; median 6). A total of 56% of circuits had citrate anticoagulation, 37% had heparin, and 7% had no anticoagulation.
  
  
  RESULTS
  Overall survival was 58%; survival differed across participating centers. Survival was lowest (51%) when CRRT was started for combined fluid overload and electrolyte imbalance. There was better survival in patients with principal diagnoses of drug intoxication (100%), renal disease (84%), tumor lysis syndrome (83%), and inborn errors of metabolism (73%); survival was lowest in liver disease/transplant (31%), pulmonary disease/transplant (45%), and bone marrow transplant (45%). Overall survival was better for children who weighed >10 kg (63 versus 43%; P = 0.001) and for those who were older than 1 yr (62 versus 44%; P = 0.007).
  
  
  CONCLUSIONS
  CRRT can be used successfully for a wide range of critically ill children. Survival is best for those who have acute, specific abnormalities and lack multiple organ involvement; sicker patients with selected diagnoses may have lower survival. Center differences might suggest opportunities to define best practices with future study.
authors: Department of Pediatrics, University of Washington School of Medicine and Children's Hospital & Regional Medical Center, Seattle, Washington 98105, USA. jordan.symons@seattlechildrens.org
authors: Jordan M
authors: JM
authors: Symons
authors: Annabelle N
authors: AN
authors: Chua
authors: Michael J G
authors: MJ
authors: Somers
authors: Michelle A
authors: MA
authors: Baum
authors: Timothy E
authors: TE
authors: Bunchman
authors: Mark R
authors: MR
authors: Benfield
authors: Patrick D
authors: PD
authors: Brophy
authors: Douglas
authors: D
authors: Blowey
authors: James D
authors: JD
authors: Fortenberry
authors: Deepa
authors: D
authors: Chand
authors: Francisco X
authors: FX
authors: Flores
authors: Richard
authors: R
authors: Hackbarth
authors: Steven R
authors: SR
authors: Alexander
authors: John
authors: J
authors: Mahan
authors: Kevin D
authors: KD
authors: McBryde
authors: Stuart L
authors: SL
authors: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012042:Registries; D017582:Renal Replacement Therapy / Q000379:methods* / Q000706:statistics & numerical data*