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Pediatric Nephrology
Published in: Pediatric Nephrology 12/2015

01-12-2015 | Original Article

Dialysis-dependent acute kidney injury in children with end-stage liver disease: prevalence, dialysis modalities and outcome

Authors: Martin Kreuzer, Dagmar Gähler, Annette C. Rakenius, Jenny Prüfe, Thomas Jack, Eva-Doreen Pfister, Lars Pape

Published in: Pediatric Nephrology | Issue 12/2015

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Abstract

Background

Acute kidney injury (AKI) is a major complication in children with hepatic failure which leads to increased morbidity and mortality. The aim of this study was to provide paediatric data on the prevalence of dialysis-dependent AKI (dAKI), the feasibility and efficacy of dialysis methods and outcome.

Methods

We conducted a retrospective analysis of 367 children listed for orthotopic liver transplantation (OLT) in our centre during the past decade.

Results

Data on 30 children (15 boys, 15 girls) were compiled for retrospective analysis, and data on dialysis feasibility and efficacy were available for 26 of these. Median age was 3.5 (range 0.4–17.7) years. Median MELD (Model For End-Stage Liver Disease) score was 33. dAKI was caused by hepato-renal syndrome in 16 of the 30 children. Twenty-one patients were treated with continuous veno-venous haemofiltration (CVVH), and nine patients received peritoneal dialysis (PD). Overall mortality was 77 %. Mortality within the PD-group was 100 % versus 67 % in the CVVH-group (p = 0.039). Urea reduction rate within the first 24 h of treatment was 12.9 % in the PD group and 23.5 % in the CVVH group (p = 0.019).

Conclusions

Children with end-stage liver disease have a high risk for dAKI associated with high mortality. CVVH is associated with better efficacy and less mortality than PD.
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Metadata
Title
Dialysis-dependent acute kidney injury in children with end-stage liver disease: prevalence, dialysis modalities and outcome
Authors
Martin Kreuzer
Dagmar Gähler
Annette C. Rakenius
Jenny Prüfe
Thomas Jack
Eva-Doreen Pfister
Lars Pape
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 12/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3156-9

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