Renal Replacement Therapies and Other Extracorporeal Therapies



Renal replacement therapy is an important component in the care of children with acute kidney injury (AKI), inborn errors of metabolism, and certain intoxications that respond inadequately to conservative measures (Table 15-1). Advancements in the treatment of children with bone marrow and solid organ transplantation, congenital cardiac disease and critically ill neonates have lead to an increase in the prevalence of AKI. Peritoneal dialysis (PD) has historically been the most common renal replacement modality for the treatment of AKI in children due to its ease of implementation. However, due to developments in equipment and techniques for hemodialysis (HD) and continuous hemofiltration, the use of these modalities now surpasses the use of PD for AKI in children. The disadvantages and advantages of each modality, the goal of therapy, the clinical status of the patient, and the institutional resources influence the choice of renal replacement modality for a specific patient. Pediatric patients require special considerations due to the wide range of body sizes encountered and due to an increased prevalence of disease states that requires renal replacement therapy in the absence of severe renal dysfunction, such as inborn errors of metabolism.


Peritoneal Dialysis Renal Replacement Therapy Continuous Renal Replacement Therapy Blood Flow Rate Intermittent Hemodialysis 
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Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Pediatric Nephrology, Department of PediatricsThe Ohio State University College of Medicine, Nationwide Children’s HospitalColumbusUSA
  2. 2.Pediatric Nephrology, Department of PediatricsUniversity of Rochester School of Medicine and Dentistry, Golisano Children’s HospitalRochesterUSA

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