Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies - results from the EurAKId registry

被引:1
作者
Deja, Anna [1 ]
Guzzo, Isabella [2 ]
Cappoli, Andrea [2 ]
Labbadia, Raffaella [2 ]
Bayazit, Aysun Karabay [3 ]
Yildizdas, Dincer [3 ]
Schmitt, Claus Peter [4 ]
Tkaczyk, Marcin [5 ]
Cvetkovic, Mirjana [6 ]
Kostic, Mirjana [6 ]
Hayes, Wesley [7 ]
Shroff, Rukshana [7 ]
Jankauskiene, Augustina [8 ,9 ]
Virsilas, Ernestas [8 ,9 ]
Longo, Germana [10 ]
Vidal, Enrico [10 ]
Mir, Sevgi [11 ]
Bulut, Ipek Kaplan [11 ]
Pasini, Andrea [12 ]
Paglialonga, Fabio [13 ]
Montini, Giovanni [13 ]
Yilmaz, Ebru [14 ]
Costa, Liane Correia [15 ]
Teixeira, Ana [15 ]
Schaefer, Franz [4 ]
机构
[1] Med Univ Warsaw, Dept Paediat Nephrol, Warsaw, Poland
[2] Bambino Gesu Childrens Hosp IRCCS, Div Nephrol, Dialysis & Transplant Unit, Rome, Italy
[3] Cukurova Univ, Fac Med, Dept Pediat Nephrol, Adana, Turkiye
[4] Heidelberg Univ Hosp, Ctr Pediat & Adolescent Med, Div Pediat Nephrol, Heidelberg, Germany
[5] Polish Mothers Mem Hosp Res Inst, Dept Pediat & Immunol, Nephrol Div, Lodz, Poland
[6] Univ Children Hosp, Dept Nephrol, Belgrade, Serbia
[7] UCL Great Ormond St Hosp, Dept Pediat Nephrol, London, England
[8] Inst Child Hlth, London, England
[9] Vilnius Univ, Inst Clin Med, Clin Pediat, Vilnius, Lithuania
[10] Univ Padua, Dept Womans & Childrens Hlth, Dialysis & Transplant Unit, Pediat Nephrol, Padua, Italy
[11] Ege Univ, Fac Med, Dept Pediat Nephrol, Izmir, Turkiye
[12] IRCCS Azienda Osped Univ Bologna, Pediat Oncol & Hematol Unit, Bologna, Italy
[13] Fdn IRCCS Ca Granda, Osped Maggiore Policlin, Pediat Nephrol Dialysis & Transplant Unit, Milan, Italy
[14] Dr Behcet Children Res & Educ Hosp, Dept Pediat Nephrol, Izmir, Turkiye
[15] Ctr Materno Infantil Norte, Dept Pediat Nephrol, Porto, Portugal
关键词
Acute kidney injury; Continuous kidney replacement therapy; Circuit lifetime; Regional citrate anticoagulation; CONTINUOUS RENAL REPLACEMENT; SYSTEMIC HEPARIN ANTICOAGULATION; REGIONAL CITRATE; HEMOFILTRATION; SURVIVAL; SIZE;
D O I
10.1007/s00467-024-06459-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37-165 h per patient). A total of 1357 circuits were utilised (3, IQR 2-6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient's age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information
引用
收藏
页码:3353 / 3362
页数:10
相关论文
共 35 条
  • [1] Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis
    Brain, Matthew
    Winson, Elizabeth
    Roodenburg, Owen
    McNeil, John
    [J]. BMC NEPHROLOGY, 2017, 18
  • [2] Continuous Renal Replacement Therapy in Critically Ill Children in the Pediatric Intensive Care Unit: A Retrospective Analysis of Real-Life Prescriptions, Complications, and Outcomes
    Buccione, Emanuele
    Guzzi, Francesco
    Colosimo, Denise
    Tedesco, Brigida
    Romagnoli, Stefano
    Ricci, Zaccaria
    L'Erario, Manuela
    Villa, Gianluca
    [J]. FRONTIERS IN PEDIATRICS, 2021, 9
  • [3] A simplified protocol of regional citrate anticoagulation with phosphate-containing solutions in infants and children treated with continuous kidney replacement therapy
    Cappoli, Andrea
    Labbadia, Raffaella
    Antonucci, Luca
    Bottari, Gabriella
    Rossetti, Emanuele
    Guzzo, Isabella
    [J]. PEDIATRIC NEPHROLOGY, 2023, 38 (11) : 3835 - 3844
  • [4] The Effect of Patient- and Treatment-Related Factors on Circuit Lifespan During Continuous Renal Replacement Therapy in Critically Ill Children
    Cortina, Gerard
    McRae, Rosemary
    Chiletti, Roberto
    Butt, Warwick
    [J]. PEDIATRIC CRITICAL CARE MEDICINE, 2020, 21 (06) : 578 - 585
  • [5] Continuous Kidney Replacement Therapy Practices in Pediatric Intensive Care Units Across Europe
    Daverio, Marco
    Cortina, Gerard
    Jones, Andrew
    Ricci, Zaccaria
    Demirkol, Demet
    Raymakers-Janssen, Paulien
    Lion, Francois
    Camilo, Cristina
    Stojanovic, Vesna
    Grazioli, Serge
    Zaoral, Tomas
    Masjosthusmann, Katja
    Vankessel, Inge
    Deep, Akash
    [J]. JAMA NETWORK OPEN, 2022, 5 (12) : E2246901
  • [6] Davies Hugh, 2006, Aust Crit Care, V19, P133, DOI 10.1016/S1036-7314(06)80026-3
  • [7] Dialysis modalities for the management of pediatric acute kidney injury
    de Galasso, Lara
    Picca, Stefano
    Guzzo, Isabella
    [J]. PEDIATRIC NEPHROLOGY, 2020, 35 (05) : 753 - 765
  • [8] Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study
    del Castillo, Jimena
    Lopez-Herce, Jesus
    Cidoncha, Elena
    Urbano, Javier
    Mencia, Santiago
    Santiago, Maria J.
    Bellon, Jose M.
    [J]. CRITICAL CARE, 2008, 12 (04):
  • [9] Current practices in pediatric continuous kidney replacement therapy: a systematic review-guided multinational modified Delphi consensus study
    Fuhrman, Dana Y. Y.
    Gist, Katja M. M.
    Akcan-Arikan, Ayse
    [J]. PEDIATRIC NEPHROLOGY, 2023, 38 (08) : 2817 - 2826
  • [10] Factors Affecting Circuit Life During Continuous Renal Replacement Therapy in Children With Liver Failure
    Goonasekera, Chulananda D.
    Wang, Justin
    Bunchman, Timothy E.
    Deep, Akash
    [J]. THERAPEUTIC APHERESIS AND DIALYSIS, 2015, 19 (01) : 16 - 22