P0103 / #697: CONTINUOUS RENAL REPLACEMENT THERAPIES (CRRT) IN IMMUNOCOMPROMISED CHILDREN ADMITTED IN PEDIATRIC INTENSIVE CARE UNIT (PICU)

Abstract

Aims & Objectives: BACKGROUND Acute Kidney Injury (AKI) appears in 26.9% of pediatric patients admitted to PICU and has a significant impact on morbidity and mortality. Of those 50% will require CRRT. These techniques offer an alternative for dialysis treatment in the management of hemodynamically unstable patients OBJECTIVE: Describe the epidemiology and outcome of immunocompromised patients (IMP) who required CRRT. Methods: Retrospective, observational and descriptive study. Medical records of patients admitted to the PICU of an academic children’s hospital in Argentina from January 2012 to December 2018 were reviewed. Patients requiring CRRT were included. Patients who needed intermittent dialysis techniques were excluded. Results: Of 1506 patients were admitted, 6.7% required CRRT (n: 102), the median age was 66 months (Q12-144), median days of hospitalization was 16 days (Q7-29). The most frequent diagnoses were 34% solid organ transplantation followed by 27% hematopoietic progenitor cell transplantation (HPCT). The prevalent secondary diagnoses were septic shock 44% and acute respiratory distress syndrome 20%. Median CRRT duration was 5 days (Q 3-9). The most commonly used dialytic mode was Continuous Venovenous Hemodialysis in 87% of patients. Overall survival was 25%. Conclusions: In our study mortality in IMP with AKI remains high, especially in those undergoing HPTC. CRRT is still a good therapeutic approach for its treatment. Early recognition of the patients who need nephroprotection strategies is crucial to reduce AKI incidence.