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- Title
Survival of infants treated with CKRT: comparing adapted adult platforms with the Carpediem™.
- Authors
Goldstein, Stuart L.; Vidal, Enrico; Ricci, Zaccaria; Paglialonga, Fabio; Peruzzi, Licia; Giordano, Mario; Laforgia, Nicola; Ronco, Claudio
- Abstract
Background: The most severely ill neonates and infants with AKI who need kidney replacement therapy have had to rely upon peritoneal dialysis, or adaptations of veno-venous continuous kidney replacement therapy (CKRT) devices for adults. Data from the Prospective Pediatric CRRT (ppCRRT) registry observed children < 10 kg had a lower survival rate than children > 10 kg (44% vs. 64%, p < 0.001). A CKRT device designed specifically for small children could improve outcomes. The Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM™) is specifically dedicated to providing CKRT for newborns and small infants. Methods: We performed a retrospective cohort analysis comparing patient severity of illness and outcomes between the ppCRRT and CARPEDIEM registries, involving 6 Italian pediatric intensive care units. Thirty-eight subjects from the CARPEDIEM registry and 84 subjects from the ppCRRT registry < 10 kg were screened for comparison. We compared patient outcomes with a weight-matched cohort (< 5 kg) of 34 patients from the CARPEDIEM registry and 48 patients from the ppCRRT registry. Results: The ppCRRT subjects had higher rates of vasoactive medication at CKRT initiation. Survival to CKRT termination was higher for CARPEDIEM subjects (33/34 vs. 21/48, p < 0.0001). Multivariable logistic regression showed that CARPEDIEM registry cohort was the only variable to retain an association with survival to CKRT discontinuation. Conclusions: We suggest children receiving CKRT using CARPEDIEM have excellent survival. Our data should be interpreted with caution given the retrospective comparison across two eras more than a decade apart.
- Subjects
ITALY; HEMODIALYSIS equipment; SURVIVAL; ACQUISITION of data methodology; RETROSPECTIVE studies; TREATMENT effectiveness; SEVERITY of illness index; MEDICAL records; DESCRIPTIVE statistics; LOGISTIC regression analysis; ACUTE kidney failure; LONGITUDINAL method; EVALUATION; CHILDREN
- Publication
Pediatric Nephrology, 2022, Vol 37, Issue 3, p667
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-021-05180-y