Acute kidney replacement therapy in children

Abstract

Choice of dialysis modality and prescription in children requires careful multidisciplinary coordination and must be tailored to the individual patient and clinical situation. Peritoneal dialysis has the advantages of simplicity and no need for vascular access and systemic anticoagulation. Patients with severe abdominal pathology may, however, be ineligible as a useable abdomen and functioning peritoneal membrane are mandatory. Peritoneal dialysis may be a poor choice if rapid correction of metabolic/electrolyte state is required. Extracorporeal hemodialysis and hemofiltration techniques and systems are well established even for the smallest children and have the advantage of high efficiency and permitting quick correction of metabolic and fluid imbalance. Intermittent hemodialysis may be poorly tolerated, however, by the critically ill patient in whom continuous therapies may be preferable. © Springer-Verlag Berlin Heidelberg 2010.