BCB Wu, WKY Chan, TY Miu, GLH Chan

Abstract

We report 17 children who were admitted to our paediatric intensive care unit (PICU) and required haemofiltration for renal replacement therapy between 1996 and 1999. Ten patients were male and 7 were female. The median age was 26 months (range 8 months to 19.7 years). The main indication for acute renal replacement was acute renal failure (n=13). Other indications included tumour lysis syndrome (n=2), removal of toxin (n=1) and end-stage renal failure with peritonitis (n=1). Continuous venovenous haemofiltration (CVVH) was performed in 12 patients, continuous venovenous haemodiafiltration (CVVHD) in 6 patients, continuous arteriovenous haemofiltration (CAVH) in 2 patients, continuous arteriovenous haemodiafiltration (CAVHD) in one patient and one patient underwent intermittent haemofiltration (IHF). The most common vascular access used was femoral vessels (n=15), followed by the subclavian veins (n=2). The median duration of haemofiltration was 22 hours (range 3 hours to 20 days). Analysis of the results showed that the drop in central venous pressure (p=0.002) and the reduction in serum urea level (p=0.0425) after haemofiltration were statistically significant. Blockage of filters and vascular accesses were the commonest complications observed. Otherwise, no other major complications were noticed in our patients. Ten patients (59%) survived and were discharged from PICU and seven patients (41%) died from the underlying diseases. We concluded that haemofiltration is an effective and safe means for acute renal replacement therapy.