Abstract P-286: CONTINUOUS RENAL REPLACEMENT THERAPY IN CRITICALLY ILL PEDIATRIC CANCER AND HEMATOPOIETIC STEM CELL TRANSPLANT PATIENTS: EPIDEMIOLOGY AND OUTCOME

Abstract

Aims & Objectives: Acute Kidney Injury (AKI) is one of the serious treatment-associated complications since the introduction of intensified treatment protocols and advanced supportive therapy in pediatric cancer and hematopoietic stem cell transplant (HSCT) patients. Continuous renal replacement therapy (CRRT) has become the most widely used renal support modality for use in these critically ill children. However, its use in this patient population with various components of multiple organ dysfunction is quite often a matter of debate. The purpose of this study was to assess epidemiology and outcome of pediatric cancer and HSCT patients who received CRRT in the pediatric intensive care unit (PICU). Methods A nationwide, retrospective study of pediatric cancer and HSCT patients who received CRRT in the 8 PICU’s from January 2006 through July 2017 in the Netherlands. Our primary outcomes were PICU- and 3-months mortality. Results Preliminary data from 54 patients were analyzed. (Table 1).The majority of patients had leukemia/lymphoma or a solid tumor as underlying cancer diagnosis, with fluid overload due to renal failure as primary PICU admission reason. PICU mortality was 31 of 54 (57.4%). After multivariable adjustment, overall fluid overload [Odds ratio (OR) 1.20 (95% CI 1.05–1.36)] and the need of vasoactive support [OR 5.20 (1.23–21.92)] were independent predictors of ortality (Table 2).Conclusions Continuous renal replacement therapy in critically ill pediatric cancer and HSCT patients is associated with a high mortality with fluid overload (especially >10%) at the beginning of CRRT and the need for vasoactive support as independent risk factors of mortality.