Kidney replacement therapy in pediatric patients on mechanical circulatory support: challenges for the pediatric nephrologist
Autor: | Natasha Afonso, Ayse Akcan-Arikan, Sebastian C Tume, Jack F. Price, Alexandra Idrovo |
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Rok vydání: | 2020 |
Předmět: |
Nephrology
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Kidney Replacement Therapy Internal medicine medicine Humans Child Intensive care medicine Heart Failure Heart transplantation business.industry Acute kidney injury Acute Kidney Injury medicine.disease Renal Replacement Therapy Pediatric nephrologist Heart failure Pediatrics Perinatology and Child Health Circulatory system Heart Transplantation Heart-Assist Devices business Destination therapy |
Zdroj: | Pediatric Nephrology. 36:1109-1117 |
ISSN: | 1432-198X 0931-041X |
Popis: | 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. |
Databáze: | OpenAIRE |
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