Characteristics of renal replacement therapy in children with acute disorders [Article in Croatian]

Abstract

The incidence of acute renal failure in children up to 18 years of age in whom the methods of renal replacement therapy were used, is 11 per million of children population/year in Croatia. More frequently, especially in newborns, infants and small children acute peritoneal dialysis (type is used. Continuous Equilibration Peritoneal Dialysis - CEPD) was used, whereas in older children acute intermittent hemodialysis. Since 2002 more often continuous veno-venous methods of renal replacement therapy have priority, especially in intensive care units. Less frequent is a combination of continuous hemofiltration or Pedijatrija danas 2007;3(2):119-131 131 intermittent hemodialysis, and peritoneal dialysis, according to changes in the clinical conditions. In the evaluation and treatment of patients algorhythms are determined, based on 25 years experience. Also organisational issues in the realisation of the available methods at all times for each child were provided. Of importance is the knowledge of indications, and possible complications of acute renal failure, associated with multi-organ disorder. For an adequate approach to all the mentioned methods of renal replacement therapy, educated medical staff (paediatric specialists in nephrology, intensive care, surgery, anaesthesiology, radiology, as well as nurses and technicians), and adequate equipment and rooms are necessary. Of importance is the maximal cooperation of all medical teams and continuous possibilities of education of staff in intensive care units and dialysis centres. Regular ambulatory check-ups of nephrologists are necessary for several years.