Kidney support therapy in the pediatric patient: Unique considerations for a unique population

David Askenazi, Rajit K. Basu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The use of kidney support therapy (KST) for use in managing patients with acute kidney injury (AKI) has expanded greatly in the last several decades. The growing use of KST modalities in children, and now in neonates, has been associated with opportunities for education, clinical research, clinical practice improvements, and outcomes research. A multitude of controversies exist in the field of pediatric KST—many of which are shared by adult critical care nephrology practice. Simultaneously, pediatric KST has led the way to a burgeoning exploration of the importance of fluid overload as it relates to KST initiation and management and also with quality improvement. In this review, we will explore and describe the paradigms contained with pediatric KST used to support children with AKI. In addition to the governing principles related to the mechanics of KST, we will describe the novel aspects of newer support machines and ethical considerations of KST provision. Anticoagulation, dose, and modality will be discussed as well as priming procedures for special considerations. The utilization of KST across pediatric populations represents the next frontier of critical care nephrology.

Original languageEnglish (US)
Pages (from-to)530-536
Number of pages7
JournalSeminars in Dialysis
Volume34
Issue number6
DOIs
StatePublished - Nov 1 2021

Funding

All authors declare no real or perceived conflicts of interest that could affect writing of the report. For full disclosure, we provide here an additional list of other author's commitments and funding sources that are not directly related to this study: Rajit K Basu serves as a consultant for BioPorto Diagnostics, bioMerieux, and BD and serves on the speaker board for Baxter. David J Askenazi serves on the speaker board for Baxter (Baxter, USA), and the Acute Kidney Injury (AKI) Foundation (Cincinnati, OH, USA). He is consultant for Baxter, CHF Solutions, and Medtronic. He also receives grant funding for studies not related to this project from Baxter, CHF solutions, and National Institutes of Health NIH-FDA (R01 FD005092) and the Pediatric and Infant Center for Acute Nephrology (PICAN). PICAN is part of the Department of Pediatrics at the University of Alabama at Birmingham (UAB), and is funded by Children's of Alabama Hospital, the Department of Pediatrics, UAB School of Medicine, and UAB’s Center for Clinical and Translational Sciences (CCTS, NIH grant UL1TR001417). All authors declare no real or perceived conflicts of interest that could affect writing of the report. For full disclosure, we provide here an additional list of other author's commitments and funding sources that are not directly related to this study: Rajit K Basu serves as a consultant for BioPorto Diagnostics, bioMerieux, and BD and serves on the speaker board for Baxter. David J Askenazi serves on the speaker board for Baxter (Baxter, USA), and the Acute Kidney Injury (AKI) Foundation (Cincinnati, OH, USA). He is consultant for Baxter, CHF Solutions, and Medtronic. He also receives grant funding for studies not related to this project from Baxter, CHF solutions, and National Institutes of Health NIH‐FDA (R01 FD005092) and the Pediatric and Infant Center for Acute Nephrology (PICAN). PICAN is part of the Department of Pediatrics at the University of Alabama at Birmingham (UAB), and is funded by Children's of Alabama Hospital, the Department of Pediatrics, UAB School of Medicine, and UAB’s Center for Clinical and Translational Sciences (CCTS, NIH grant UL1TR001417).

ASJC Scopus subject areas

  • Nephrology

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