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Acute dialysis in children: results of a European survey

  • Isabella GuzzoEmail author
  • Lara de Galasso
  • Sevgi Mir
  • Ipek Kaplan Bulut
  • Augustina Jankauskiene
  • Vilmanta Burokiene
  • Mirjana Cvetkovic
  • Mirjana Kostic
  • Aysun Karabay Bayazit
  • Dincer Yildizdas
  • Claus Peter Schmitt
  • Fabio Paglialonga
  • Giovanni Montini
  • Ebru Yilmaz
  • Jun Oh
  • Lutz Weber
  • Christina Taylan
  • Wesley Hayes
  • Rukshana Shroff
  • Enrico Vidal
  • Luisa Murer
  • Francesca Mencarelli
  • Andrea Pasini
  • Ana Teixeira
  • Alberto Caldas Afonso
  • Dorota Drozdz
  • Franz Schaefer
  • Stefano Picca
  • For the ESCAPE Network
Original Article
  • 46 Downloads

Abstract

The number of children with acute kidney injury (AKI) requiring dialysis is increasing. To date, systematic analysis has been largely limited to critically ill children treated with continuous renal replacement therapy (CRRT). We conducted a survey among 35 European Pediatric Nephrology Centers to investigate dialysis practices in European children with AKI. Altogether, the centers perform dialysis in more than 900 pediatric patients with AKI per year. PD and CRRT are the most frequently used dialysis modalities, accounting for 39.4% and 38.2% of treatments, followed by intermittent HD (22.4%). In units treating more than 25 cases per year and in those with cardiothoracic surgery programs, PD is the most commonly chosen dialysis modality. Also, nearly one quarter of centers, in countries with a gross domestic product below $35,000/year, do not utilize CRRT at all. Dialysis nurses are exclusively in charge of CRRT management in 45% of the cases and pediatric intensive care nurses in 25%, while shared management is practiced in 30%. In conclusion, this survey indicates that the choice of treatment modalities for dialysis in children with AKI in Europe is affected by the underlying ethiology of the disease, organization/set-up of centers and socioeconomic conditions. PD is utilized as often as CRRT, and also intermittent HD is a commonly applied treatment option. A prospective European AKI registry is planned to provide further insights on the epidemiology, management and outcomes of dialysis in pediatric AKI.

Keywords

Acute kidney injury (AKI) Peritoneal dialysis (PD) Intermittent hemodialysis (HD) Continuous renal replacement therapy (CRRT) 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study was approved by the Ethics Board at the Institute for Scientific Research, Bambino Gesù Children’s Hospital

Informed consent

The Institutional Review Board waived the need for informed consent.

Supplementary material

40620_2019_606_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)

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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  • Isabella Guzzo
    • 1
    Email author
  • Lara de Galasso
    • 1
  • Sevgi Mir
    • 2
  • Ipek Kaplan Bulut
    • 2
  • Augustina Jankauskiene
    • 3
  • Vilmanta Burokiene
    • 4
  • Mirjana Cvetkovic
    • 5
  • Mirjana Kostic
    • 5
  • Aysun Karabay Bayazit
    • 6
  • Dincer Yildizdas
    • 6
  • Claus Peter Schmitt
    • 7
  • Fabio Paglialonga
    • 8
  • Giovanni Montini
    • 8
  • Ebru Yilmaz
    • 9
  • Jun Oh
    • 10
  • Lutz Weber
    • 11
  • Christina Taylan
    • 11
  • Wesley Hayes
    • 12
  • Rukshana Shroff
    • 12
  • Enrico Vidal
    • 13
  • Luisa Murer
    • 13
  • Francesca Mencarelli
    • 14
  • Andrea Pasini
    • 14
  • Ana Teixeira
    • 15
  • Alberto Caldas Afonso
    • 15
  • Dorota Drozdz
    • 16
  • Franz Schaefer
    • 7
  • Stefano Picca
    • 1
  • For the ESCAPE Network
  1. 1.Nephrology and Dialysis Unit, Pediatric Subspecialties Department, Institute for Scientific ResearchBambino Gesù Children’s HospitalRomeItaly
  2. 2.Ege University Faculty of MedicineIzmirTurkey
  3. 3.Clinic of Children Diseases, Institute of Clinical MedicineVilnius UniversityVilniusLithuania
  4. 4.Children Hospital, Affiliate of Vilnius University Hospital Santaros KlinikosVilniusLithuania
  5. 5.University Children HospitalBelgradeSerbia
  6. 6.Department of Pediatric NephrologyCukurova University Faculty of MedicineAdanaTurkey
  7. 7.Division of Pediatric NephrologyCenter for Pediatrics and Adolescent Medicine, University of HeidelbergHeidelbergGermany
  8. 8.Pediatric Nephrology, Dialysis and Transplant UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  9. 9.Behcet Children’s HospitalIzmirTurkey
  10. 10.University Children’s HospitalUniversity Medical Center Hamburg-EppendorfHamburgGermany
  11. 11.Children’s and Adolescents’ Hospital, University Hospital of CologneCologneGermany
  12. 12.Great Ormond Street Hospital for Children, NHS Foundation TrustLondonUK
  13. 13.Azienda Ospedaliera-University of PaduaPaduaItaly
  14. 14.S Orsola-Malpighi HospitalBolognaItaly
  15. 15.Centro Materno-Infantil do NortePortoPortugal
  16. 16.Jagiellonian University Medical CollegeKrakowPoland

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