Characteristics of pediatric continuous renal replacement therapies in hospitals with pediatric intensive care units in Japan

Introduction: Information on the implementation of continuous renal replacement therapy (CRRT) in pediatric intensive care units (PICUs) is limited. We investigated the real-world practice of this therapy in Japan.Methods: We conducted a cross-sectional survey of 26 hospitals with PICUs in Japan. One physician per hospital responded to the questionnaire.Results: Fewer than half of the hospitals followed the CRRT practice guidelines; treatment options were often selected at a physician's discretion. PICUs varied widely in continuous renal replacement settings, circuit priming methods, frequency of circuit exchange, and policies for using CRRT in sepsis. Only two anticoagulants were used: nafamostat mesylate and unfractionated heparin. Most units did not change the nutritional dosage according to CRRT use. Many facilities were proactive concerning rehabilitation.Conclusion: Nafamostat-centered anticoagulation management was unique to Japan. Our results may help identify areas where additional clinical studies are needed to standardize CRRT practice.