TY - JOUR
T1 - Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy
T2 - a WE-ROCK study
AU - WE-ROCK Collaborative
AU - Menon, Shina
AU - Starr, Michelle C.
AU - Zang, Huaiyu
AU - Collins, Michaela
AU - Damian, Mihaela A.
AU - Fuhrman, Dana
AU - Krallman, Kelli
AU - Soranno, Danielle E.
AU - Webb, Tennille N.
AU - Slagle, Cara
AU - Joseph, Catherine
AU - Martin, Susan D.
AU - Mohamed, Tahagod
AU - Beebe, Morgan E.
AU - Ricci, Zaccaria
AU - Ollberding, Nicholas
AU - Selewski, David
AU - Gist, Katja M.
AU - Zong, Alison
AU - Zinger, Marcia
AU - Woods, Megan
AU - Wang, Janet
AU - Wallace, Samantha
AU - Van Wyk, Brynna
AU - Twombley, Katherine
AU - Taylor, Sue
AU - Strack, P. J.
AU - Sinha, Vidushi
AU - Schneider, Elizabeth
AU - Serratore, Alyssa
AU - Potts, Jessica
AU - Porter, Joshua
AU - Plomaritas, Katherine
AU - Meyer, Christopher J.
AU - Lusk, Jennifer
AU - Kanwar, Kate
AU - Jain, Sonal
AU - Hilgenkamp, Madison R.
AU - Gales, Barbara
AU - Gahring, Kim
AU - Farma, Simrandeep
AU - Ehrlich, Jennifer L.
AU - Dash, Anwesh
AU - Burrell, Ambra
AU - Brown, Cheryl L.
AU - Brown, Erica Blender
AU - Bixler, Elizabeth
AU - Alvarez, T. Christine E.
AU - Zappitelli, Michael
AU - Solomon, Sonia
N1 - © 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.
PY - 2025/1
Y1 - 2025/1
N2 - BACKGROUND: Continuous kidney replacement therapy (CKRT) is often used for acute kidney injury (AKI) or fluid overload (FO) in children ≤ 10 kg. Intensive care unit (ICU) mortality in children ≤ 10 kg reported by the prospective pediatric CRRT (ppCRRT, 2001-2003) registry was 57%. We aimed to evaluate characteristics associated with ICU mortality using a contemporary registry.METHODS: The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry is a retrospective, multinational, observational study of children and young adults aged 0-25 years receiving CKRT (2015-2021) for AKI or FO. This analysis included patients ≤ 10 kg at hospital admission.PRIMARY AND SECONDARY OUTCOMES: ICU mortality and major adverse kidney events at 90 days (MAKE-90) defined as death, persistent kidney dysfunction, or dialysis within 90 days, respectively.RESULTS: A total of 210 patients were included (median age 0.53 years (IQR, 0.1, 0.9)). ICU mortality was 46.5%. MAKE-90 occurred in 150/207 (72%). CKRT was initiated at a median 3 days (IQR 1, 9) after ICU admission and lasted a median 6 days (IQR 3, 16). On multivariable analysis, pediatric logistic organ dysfunction score (PELOD-2) at CKRT initiation was associated with increased odds of ICU mortality (aOR 2.64, 95% CI 1.68-4.16), and increased odds of MAKE-90 (aOR 2.2, 95% CI 1.31-3.69). Absence of comorbidity was associated with lower MAKE-90 (aOR 0.29, 95%CI 0.13-0.65).CONCLUSIONS: We report on a contemporary cohort of children ≤ 10 kg treated with CKRT for acute kidney injury and/or fluid overload. ICU mortality is decreased compared to ppCRRT. The extended risk of death and morbidity at 90 days highlights the importance of close follow-up.
AB - BACKGROUND: Continuous kidney replacement therapy (CKRT) is often used for acute kidney injury (AKI) or fluid overload (FO) in children ≤ 10 kg. Intensive care unit (ICU) mortality in children ≤ 10 kg reported by the prospective pediatric CRRT (ppCRRT, 2001-2003) registry was 57%. We aimed to evaluate characteristics associated with ICU mortality using a contemporary registry.METHODS: The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry is a retrospective, multinational, observational study of children and young adults aged 0-25 years receiving CKRT (2015-2021) for AKI or FO. This analysis included patients ≤ 10 kg at hospital admission.PRIMARY AND SECONDARY OUTCOMES: ICU mortality and major adverse kidney events at 90 days (MAKE-90) defined as death, persistent kidney dysfunction, or dialysis within 90 days, respectively.RESULTS: A total of 210 patients were included (median age 0.53 years (IQR, 0.1, 0.9)). ICU mortality was 46.5%. MAKE-90 occurred in 150/207 (72%). CKRT was initiated at a median 3 days (IQR 1, 9) after ICU admission and lasted a median 6 days (IQR 3, 16). On multivariable analysis, pediatric logistic organ dysfunction score (PELOD-2) at CKRT initiation was associated with increased odds of ICU mortality (aOR 2.64, 95% CI 1.68-4.16), and increased odds of MAKE-90 (aOR 2.2, 95% CI 1.31-3.69). Absence of comorbidity was associated with lower MAKE-90 (aOR 0.29, 95%CI 0.13-0.65).CONCLUSIONS: We report on a contemporary cohort of children ≤ 10 kg treated with CKRT for acute kidney injury and/or fluid overload. ICU mortality is decreased compared to ppCRRT. The extended risk of death and morbidity at 90 days highlights the importance of close follow-up.
KW - Acute Kidney Injury/therapy
KW - Adolescent
KW - Adult
KW - Child
KW - Child, Preschool
KW - Continuous Renal Replacement Therapy/methods
KW - Female
KW - Hospital Mortality
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Intensive Care Units/statistics & numerical data
KW - Male
KW - Registries/statistics & numerical data
KW - Retrospective Studies
KW - Treatment Outcome
KW - Water-Electrolyte Imbalance/therapy
KW - Young Adult
UR - https://www.scopus.com/pages/publications/85202508472
U2 - 10.1007/s00467-024-06438-x
DO - 10.1007/s00467-024-06438-x
M3 - Article
C2 - 39164502
AN - SCOPUS:85202508472
SN - 0931-041X
VL - 40
SP - 253
EP - 264
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 1
ER -