[Acute renal replacement therapy in pediatrics].
In pediatric intensive care unit, the available modalities of acute renal replacement therapy include intermittent hemodialysis, peritoneal dialysis and continuous renal replacement therapies. No prospective studies have evaluated to date the effect of dialysis modality on the outcomes of children. The decision about dialysis modality should therefore be based on local expertise, resources available, and the patient's clinical status. Poor hemodynamic tolerance of intermittent hemodialysis is a common problem in critically ill patients. Moreover, many pediatric intensive care units are not equipped with dedicated water circuit. Peritoneal dialysis, a simple and inexpensive alternative, is the most widely available form of acute renal replacement therapy. However, its efficacy may be limited in critically ill patients. The use of continuous renal replacement therapy permits usually to reach a greater estimated dialysis dose, a better control of fluid balance, and additionally, to provide adequate nutrition.
Unité de réanimation pédiatrique, pôle anesthésie-réanimation, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35203 Rennes cedex 2, France; CIC-P Inserm 0203, université Rennes-1, 35033 Rennes, France. Electronic address: theophile.gaillot@chu-rennes.fr.
T
T
Gaillot
B
B
Ozanne
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P
Bétrémieux
O
O
Tirel
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C
Ecoffey
D058186:Acute Kidney Injury / Q000628:therapy*; D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017583:Hemodiafiltration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008991:Monitoring, Physiologic; D010372:Pediatrics / Q000379:methods*; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D017582:Renal Replacement Therapy / Q000379:methods*; D012151:Resuscitation; D062666:Vascular Access Devices
D000925:Anticoagulants
Acute kidney injury; Dialyse péritonéale; Hemodialysis; Hémodiafiltration continue; Hémodialyse intermittente; Insuffisance rénale aiguë; Pediatric intensive care unit; Peritoneal dialysis; Renal replacement therapy; Réanimation pédiatrique; Épuration extrarénale