[Continuous renal replacement therapy in children with acute renal failure--5 years of experience].

Continuous renal replacement therapy (CRRT) has became a modality of choice in chidren with acute renal failure (ARF), especially in cases of multiorgan failure (MOF) and in hemodynamically unstable patients in whom regular hemodialysis is difficult to reform. Newborns and infants with contraindications to peritoneal dialysis are another group of patients treated with CRRT. Retrospective analysis of CRRT therapy in 112 patients treated with (CVVHD, CVVH, CVVHDF, SCUF-continuous veno-venous hemodialysis/hemofiltration/ hemodiafiltration/ultrafiltration) between 2000-2005 is presented. Indication to CRRT was MOF (n=23, 20%), complications post-liver transplant (n=33, 29%), congenital metabolic defects (n=5, 4.5%), complications of cancer or chemotherapy (n=11, 9.8%) and other causes of ARF (n=40, 36.7%). Overall mortality was 36.6%. The highest rate was seen in children between 0-2 years of age (52,3%) and in patients with congenital metabolic diseases (80%). When adjusted to specific modality--the highest mortality was seen in patients treated with CVVHF (55.4%), while lower was in cases treated with CVVHD (37.8%) and CVVHDF (35.4%). Among older children higher mortality was seen in patients with mean arterial pressure (MAP) <70 mmHg (68.4%), compared to patients with MAP >70 mmHg (23.1%).