Acute Kidney Injury in Children: Kidney Replacement Therapy (A Literature Review). Part 3

Острое повреждение почек у детей: заместительная почечная терапия (обзор литературы). Часть 3*
Baiko S.V. Muzurov A.L. Shepetov A.M. Shavkin A.L. Rumyantsev A.L. Kulakova E.N. Ganiev B.K.
2025 Professionalnye Izdaniya

Pediatrics Eastern Europe
2025 #13 Issue 4 508 - 537 pp.

Acute kidney injury (AKI) is a condition in which kidney replacement therapy (KRT) methods such as intermittent hemodialysis (IHD), peritoneal dialysis (PD), and continuous KRT methods (continuous veno-venous hemo(dia)filtration (CVVH(D), etc.) are often used to save a child’s life. The aim of this review is to summarize the available information on indications and choice of KRT method, the main principles, features, advantages and disadvantages of IHD, PD, CVVH(D), and to present protocols for initial and subsequent dialysis therapy in AKI children. Various advances in the use of current KRT methods, newly designed dialysis machines for infants, and measures for preventing cardiopulmonary complications have led to improved AKI outcomes. Changes in PD include the use of biocompatible solutions (pH neutral, and with bicarbonate buffer) and improved ultrafiltration management (automatic and continuous flow PD). The introduction of high-flow CVVH(D) improved toxic metabolites elimination, resulting in increased patients’ survival. The identification of a significant association between the degree of hyperhydration and the risk of mortality in AKI children allowed justifying an earlier KRT initiation. The article presents protocols for prescribing all available KRT methods, which will significantly facilitate preparing initial and follow-up dialysis therapy programs for practicing physicians. KRT methods are an integral part of the treatment of many AKI children, and their continuous enhancement gives hope for further improvement in outcomes.

acute kidney injury (AKI) , children , continuous veno-venous hemo(dia)filtration (CVVH(D)) , hemodialysis , kidney replacement therapy (KRT) , peritoneal dialysis

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Belarusian State Medical University, Minsk, Belarus
Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
Children’s City Clinical Hospital of St. Vladimir, Moscow, Russian Federation
Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
Children’s Urban Multidisciplinary Clinical Specialized Center of High Medical Technologies, Saint Petersburg, Russian Federation
N.F. Filatov Moscow City Children’s Clinical Hospital, Moscow, Russian Federation
N.N. Burdenko Voronezh State Medical University, Voronezh, Russian Federation
Samarkand Regional Multidisciplinary Children’s Medical Center, Samarkand, Uzbekistan

Belarusian State Medical University
Russian Medical Academy of Continuous Professional Education
Children’s City Clinical Hospital of St. Vladimir
Kazakh National Medical University named after S.D. Asfendiyarov
Children’s Urban Multidisciplinary Clinical Specialized Center of High Medical Technologies
N.F. Filatov Moscow City Children’s Clinical Hospital
N.N. Burdenko Voronezh State Medical University
Samarkand Regional Multidisciplinary Children’s Medical Center

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