RENAL REPLACEMENT THERAPIES FOR CRITICALLY ILL PEDIATRIC-PATIENTS

It could be a a great challenge for a nephrologist to prescribe a rena l replacement therapy far a critically III, hemodynamically unstable p ediatric patient. Intermittent hemodialysis and peritoneal dialysis fr equently fall short of being an optimal renal replacement therapy for such a patient. Continuous hemofiltration is offering new alternatives that can deliver sufficient clearance to meet the needs of a critical ly ill child. High fluid intake required for total parenteral nutritio n and medications can easily be fulfilled by these modalities without compromising the cardivascular system. Of these techniques, continuous veno-venous hemofiltration is superior to continuous arterio-venous h emofiltration because it delivers a consistent ultrafiltration rate de pendent on pump-driven blood flow and does not require the insertion o f a large-bore catheter into an artery. Thus, various modalities of he mofiltration can offer an alternative to the critically ill child with acute renal failure.