Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study.
Acute kidney injury
Continuous kidney replacement therapy
Critically ill infants
Fluid overload
MAKE-90
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
20 Aug 2024
20 Aug 2024
Historique:
received:
10
04
2024
accepted:
07
06
2024
revised:
23
05
2024
medline:
21
8
2024
pubmed:
21
8
2024
entrez:
20
8
2024
Statut:
aheadofprint
Résumé
Continuous kidney replacement therapy (CKRT) is often used for acute kidney injury (AKI) or fluid overload (FO) in children ≤ 10 kg. Intensive care unit (ICU) mortality in children ≤ 10 kg reported by the prospective pediatric CRRT (ppCRRT, 2001-2003) registry was 57%. We aimed to evaluate characteristics associated with ICU mortality using a contemporary registry. The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry is a retrospective, multinational, observational study of children and young adults aged 0-25 years receiving CKRT (2015-2021) for AKI or FO. This analysis included patients ≤ 10 kg at hospital admission. ICU mortality and major adverse kidney events at 90 days (MAKE-90) defined as death, persistent kidney dysfunction, or dialysis within 90 days, respectively. A total of 210 patients were included (median age 0.53 years (IQR, 0.1, 0.9)). ICU mortality was 46.5%. MAKE-90 occurred in 150/207 (72%). CKRT was initiated at a median 3 days (IQR 1, 9) after ICU admission and lasted a median 6 days (IQR 3, 16). On multivariable analysis, pediatric logistic organ dysfunction score (PELOD-2) at CKRT initiation was associated with increased odds of ICU mortality (aOR 2.64, 95% CI 1.68-4.16), and increased odds of MAKE-90 (aOR 2.2, 95% CI 1.31-3.69). Absence of comorbidity was associated with lower MAKE-90 (aOR 0.29, 95%CI 0.13-0.65). We report on a contemporary cohort of children ≤ 10 kg treated with CKRT for acute kidney injury and/or fluid overload. ICU mortality is decreased compared to ppCRRT. The extended risk of death and morbidity at 90 days highlights the importance of close follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
Continuous kidney replacement therapy (CKRT) is often used for acute kidney injury (AKI) or fluid overload (FO) in children ≤ 10 kg. Intensive care unit (ICU) mortality in children ≤ 10 kg reported by the prospective pediatric CRRT (ppCRRT, 2001-2003) registry was 57%. We aimed to evaluate characteristics associated with ICU mortality using a contemporary registry.
METHODS
METHODS
The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry is a retrospective, multinational, observational study of children and young adults aged 0-25 years receiving CKRT (2015-2021) for AKI or FO. This analysis included patients ≤ 10 kg at hospital admission.
PRIMARY AND SECONDARY OUTCOMES
METHODS
ICU mortality and major adverse kidney events at 90 days (MAKE-90) defined as death, persistent kidney dysfunction, or dialysis within 90 days, respectively.
RESULTS
RESULTS
A total of 210 patients were included (median age 0.53 years (IQR, 0.1, 0.9)). ICU mortality was 46.5%. MAKE-90 occurred in 150/207 (72%). CKRT was initiated at a median 3 days (IQR 1, 9) after ICU admission and lasted a median 6 days (IQR 3, 16). On multivariable analysis, pediatric logistic organ dysfunction score (PELOD-2) at CKRT initiation was associated with increased odds of ICU mortality (aOR 2.64, 95% CI 1.68-4.16), and increased odds of MAKE-90 (aOR 2.2, 95% CI 1.31-3.69). Absence of comorbidity was associated with lower MAKE-90 (aOR 0.29, 95%CI 0.13-0.65).
CONCLUSIONS
CONCLUSIONS
We report on a contemporary cohort of children ≤ 10 kg treated with CKRT for acute kidney injury and/or fluid overload. ICU mortality is decreased compared to ppCRRT. The extended risk of death and morbidity at 90 days highlights the importance of close follow-up.
Identifiants
pubmed: 39164502
doi: 10.1007/s00467-024-06438-x
pii: 10.1007/s00467-024-06438-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Emily Ahern
(E)
Ayse Akcan Arikan
(AA)
Issa Alhamoud
(I)
Rashid Alobaidi
(R)
Pilar Anton-Martin
(P)
Shanthi S Balani
(SS)
Matthew Barhight
(M)
Abby Basalely
(A)
Amee M Bigelow
(AM)
Gabriella Bottari
(G)
Andrea Cappoli
(A)
Eileen A Ciccia
(EA)
Denise Colosimo
(D)
Gerard Cortina
(G)
Sara De la Mata Navazo
(S)
Gabrielle DeAbreu
(G)
Akash Deep
(A)
Kathy L Ding
(KL)
Kristin J Dolan
(KJ)
Sarah NFernandez Lafever
(SN)
Ben Gelbart
(B)
Stephen M Gorga
(SM)
Francesco Guzzi
(F)
Isabella Guzzo
(I)
Taiki Haga
(T)
Elizabeth Harvey
(E)
Denise C Hasson
(DC)
Taylor Hill-Horowitz
(T)
Haleigh Inthavong
(H)
Ahmad Kaddourah
(A)
Aadil Kakajiwala
(A)
Aaron D Kessel
(AD)
Sarah Korn
(S)
David M Kwiatkowski
(DM)
Jasmine Lee
(J)
Laurance Lequier
(L)
Tina Madani Kia
(TM)
Kenneth E Mah
(KE)
Eleonora Marinari
(E)
Catherine Morgan
(C)
Theresa A Mottes
(TA)
Melissa A Muff-Luett
(MA)
Siva Namachivayam
(S)
Tara M Neumayr
(TM)
Jennifer Nhan
(J)
Abigail O'Rourke
(A)
Matthew G Pinto
(MG)
Dua Qutob
(D)
Valeria Raggi
(V)
Stephanie Reynaud
(S)
Zachary A Rumlow
(ZA)
María JSantiago Lozano
(MJ)
Emily See
(E)
Carmela Serpe
(C)
Alyssa Serratore
(A)
Ananya Shah
(A)
Weiwen V Shih
(WV)
HStella Shin
(H)
Sonia Solomon
(S)
Rachana Srivastava
(R)
Natalja L Stanski
(NL)
Erin K Stenson
(EK)
Amy E Strong
(AE)
Susan A Taylor
(SA)
Sameer V Thadani
(SV)
Amanda M Uber
(AM)
Brynna Van Wyk
(B)
Emily E Zangla
(EE)
Michael Zappitelli
(M)
T Christine E Alvarez
(TCE)
Elizabeth Bixler
(E)
Erica Blender Brown
(EB)
Cheryl L Brown
(CL)
Ambra Burrell
(A)
Anwesh Dash
(A)
Jennifer L Ehrlich
(JL)
Simrandeep Farma
(S)
Kim Gahring
(K)
Barbara Gales
(B)
Madison R Hilgenkamp
(MR)
Sonal Jain
(S)
Kate Kanwar
(K)
Jennifer Lusk
(J)
Christopher J Meyer
(CJ)
Katherine Plomaritas
(K)
Joshua Porter
(J)
Jessica Potts
(J)
Alyssa Serratore
(A)
Elizabeth Schneider
(E)
Vidushi Sinha
(V)
P J Strack
(PJ)
Sue Taylor
(S)
Katherine Twombley
(K)
Brynna Van Wyk
(B)
Samantha Wallace
(S)
Janet Wang
(J)
Megan Woods
(M)
Marcia Zinger
(M)
Alison Zong
(A)
Informations de copyright
© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.
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