Dialytic dose in pediatric continuous renal replacement therapy patients

Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Stefano Romagnoli

Research output: Contribution to journalReview articlepeer-review

Abstract

Although universally recognized as a crucial component of renal replacement therapy (RRT), dialytic dose has not been investigated in children with renal failure, differently from the adult population. Consequently, clear indications on the adequacy of continuous RRTin pediatric population is currently missing and wide variations in clinical practice exist worldwide. Fluid balance has been identified as a key factor in affecting outcomes these patients. Nonetheless, the concept and the precise evaluation of the dialytic dose for continuous pediatric RRTseems crucial, especially in light of the small body surface area of neonates and infants that might result into a difficult dose calculation. The present review clearly demonstrates that dialytic dose in pediatric RRT has been underestimated by scientific literature. Nowadays, the absence of any specific dedicated prospective study and the tendency to overlook theoretical basis of pediatric dialytic dose have led to the absence of a standard prescription: worldwide clinical practice ranges from very high doses to lower ones, also depending on different ways of estimating patients' sizes and solutes' volume of distribution. Large structured studies are warranted in order to define a reference dialytic dose for critically ill children, capable to cope an adequate solute control to gentle and safe treatments.

Original languageEnglish
Pages (from-to)366-373
Number of pages8
JournalMinerva Pediatrica
Volume68
Issue number5
Publication statusPublished - Oct 1 2016

Keywords

  • Child
  • Renal dialysis
  • Renal replacement therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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