CA.R.PE.DI.E.M. (Cardio-Renal Pediatric Dialysis Emergency Machine): Evolution of continuous renal replacement therapies in infants. A personal journey

Claudio Ronco, Francesco Garzotto, Zaccaria Ricci

Research output: Contribution to journalArticle

Abstract

Pedriatric acute kidney injury (AKI) is a well-described clinical syndrome that is characterized by a reduction of both the urine output and glomerular filtration rate. AKI in critically ill children is typically associated with multiple organ dysfunction. A dramatic increase in the incidence of AKI in pediatric intensive care units has been observed in the last 10 years. Unfortunately, the absence of sufficiently effective preventive and therapeutic measures at the present time has limited significant improvements in AKI care. Morality in patients with severe AKI remains unacceptably high (>50 %), with renal replacement therapy (RRT) remaining the most effective form of support for these patients. Despite technological advances during the last 10 years which have resulted in the development of the so-called "third-generation dialysis machines" that are characterized by the highest level of safety and accuracy, a truly pedriatric RRT system has never been developed. Consequently, dialysis/hemofiltration in critically ill children is currently performed by adapting adult systems to the much smaller pediatric patients. In particular, research in this field should focus on children weighing less than 10 kg for whom the delivery of RRT is a clinical and technological challenge. We describe here the evolution of pediatric RRT during the last 30 years and report in detail on the CARPE-DIEM project, which has recently been established to finally provide neonates and infants with a reliable dialysis machine that is specifically designed for this age group.

Original languageEnglish
Pages (from-to)1203-1211
Number of pages9
JournalPediatric Nephrology
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2012

Keywords

  • Acute renal failure
  • Continuous hemofiltration
  • Pediatric acute kidney injury
  • Pediatric CRRT
  • Pediatric dialysis
  • Perinatal ARF

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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