What question did this study set out to answer?

This research aims to evaluate how fluid removal affects organ function improvement in children receiving CRRT for acute kidney injury and fluid overload.

March 17, 2026Journal of Pediatric Intensive Care0 citationsOpen Access

Fluid Removal in Children on Continuous Renal Replacement Therapy Improves Organ Dysfunction Score

STSachin TadphaleArkansas Children's Hospital PLPeter M. LuckettChildren's Hospital of Wisconsin RQRaymond QuigleyThe University of Texas Southwestern Medical Center

Puntos clave

This research aims to evaluate how fluid removal affects organ function improvement in children receiving CRRT for acute kidney injury and fluid overload.
Conducted a retrospective review of pediatric patients in a tertiary ICU over three years.
Assessed changes in non-renal Pediatric Logistic Organ Dysfunction score after 3 days of CRRT.
Categorized patients based on improvement in the PELOD score.
Performed multivariable logistic regression to identify predictors of improvement.
Higher PELOD scores at CRRT initiation were associated with better improvement (OR 1.11, p<0.001).
Infant-age patients had significantly higher improvement odds (OR 4.53, p=0.02).
Greater fluid removal during the first 3 days of CRRT correlated with score improvement (OR 1.05, p=0.01).
Fluid overload at initiation was linked to worsening scores (OR 0.66, p=0.02).
An oncologic diagnosis was also associated with poor outcomes (OR 0.28, p=0.03).

Resumen

Objectives: To assess impact of fluid removal on improvement in organ function in children who received continuous renal replacement therapy (CRRT) for management of acute kidney injury (AKI) and/or fluid overload (FO). Methods: A retrospective review of eligible patients admitted to a tertiary level intensive care unit over a 3-year period was performed. Improvement in non-renal organ function, the primary outcome, was defined as decrease in non-renal component of Pediatric Logistic Organ Dysfunction (PELOD) score on day 3 of CRRT. The cohort was categorized into Group 1 (improvement) and Group 2 (no improvement or worsening) in non-renal PELOD score. Multivariable logistic regression analysis was performed to identify independent predictors. Results: A higher PELOD score at CRRT initiation (OR 1.11, 95% CI 1.05, 1.18, p<0.001), belonging to infant-age group (OR 4.53, 95% CI 4.40, 5.13, p=0.02) and greater fluid removal during initial 3 days of CRRT (OR 1.05, 95% CI 1.01, 1.10, p=0.01) were associated with an improvement in non-renal PELOD score at day 3 of CRRT. FO at CRRT initiation (OR 0.66, 95% CI 0.46, 0.93, p=0.02) and having an underlying oncologic diagnosis (OR 0.28, 95% CI 0.09, 0.85, p=0.03) were associated with worsening of non-renal PELOD score at day 3 of CRRT. Conclusions: Careful consideration of certain modifiable patient and/or fluid removal kinetic factors may have an impact on outcomes.

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Cite This Study

Tadphale et al. (Thu,) studied this question.

synapsesocial.com/papers/69b8ef12deb47d591b8c51fc https://doi.org/https://doi.org/10.53391/2146-4618.1069

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