Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry

• Published in: Pediatric nephrology (Berlin, West) West), 2024-11, Vol.39 (11), p.3353-3362
• Main Authors: Deja, Anna, Guzzo, Isabella, Cappoli, Andrea, Labbadia, Raffaella, Bayazit, Aysun Karabay, Yildizdas, Dincer, Schmitt, Claus Peter, Tkaczyk, Marcin, Cvetkovic, Mirjana, Kostic, Mirjana, Hayes, Wesley, Shroff, Rukshana, Jankauskiene, Augustina, Virsilas, Ernestas, Longo, Germana, Vidal, Enrico, Mir, Sevgi, Bulut, Ipek Kaplan, Pasini, Andrea, Paglialonga, Fabio, Montini, Giovanni, Yilmaz, Ebru, Correia Costa, Liane, Teixeira, Ana, Schaefer, Franz
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Anticoagulants - administration & dosage; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Child; Child, Preschool; Children; Continuous Renal Replacement Therapy - instrumentation; Continuous Renal Replacement Therapy - methods; Continuous Renal Replacement Therapy - statistics & numerical data; Dialysis; Female; Heparin; Heparin - administration & dosage; Humans; Infant; Jugular vein; Kidneys; Male; Medicine; Medicine & Public Health; Multivariate analysis; Nephrology; Original; Original Article; Patients; Pediatrics; Prospective Studies; Registries - statistics & numerical data; Renal replacement therapy; Time Factors; Treatment Outcome; Urology; Venous access; What's New in Dialysis
• ISSN: 0931-041X; 1432-198X; 1432-198X
• DOI: 10.1007/s00467-024-06459-6

Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p