Kidney Replacement Therapy in Pediatric Patients on Mechanical Circulatory Support: Challenges for the Pediatric Nephrologist

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2020 May 29

PMID 32462258

Citations 1

Authors

Alexandra Idrovo

Natasha Afonso

Jack Price

Sebastian Tume

Ayse Akcan-Arikan

Affiliations

Soon will be listed here.

Abstract

The use of mechanical circulatory support (MCS) therapies in children with medically refractory cardiac failure has increased over the past two decades. With the growing experience and expertise, MCS is currently offered as a bridge to recovery or heart transplantation and in some cases even as destination therapy. Acute kidney injury (AKI) is common in patients with end-stage heart failure (ESHF). When severe AKI develops requiring kidney replacement therapy (KRT), these patients present unique challenges for the pediatric nephrology team. The use of KRT has not been adequately described in children with ESHF on the newer MCS. We also present original case series data from our center experience. The purpose of this review is to familiarize the reader with the current MCS technologies, approach to their selection, how they interact when combined with current KRT circuits, and distinguish similarities and differences. We will attempt to highlight the distinctive features of each technology, specifically focusing on growing trends in use of continuous-flow ventricular assist devices (CF-VAD) as it poses additional challenges to the pediatric nephrologist.

Citing Articles

Long-term kidney outcomes in pediatric continuous-flow ventricular assist device patients.

Idrovo A, Hollander S, Neumayr T, Bell C, Munoz G, Choudhry S Pediatr Nephrol. 2023; 39(4):1289-1300.

PMID: 37971519 DOI: 10.1007/s00467-023-06190-8.

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