Abstract
Chronic kidney disease (CKD) and acute kidney injury (AKI) requiring renal replacement therapy (RRT) by dialysis are rare conditions in pediatric patients. In pediatric patients with CKD, dialysis is mainly performed using peritoneal dialysis (PD) or intermittent hemodialysis (HD). In patients with AKI, continuous renal replacement therapy (CRRT) using hemofiltration, hemodialysis, or both techniques can be used. This chapter reviews (1) physiology and epidemiology of kidney disease and dialysis in children and (2) pharmacokinetic principles to be considered for developing pediatric dose recommendations under different dialysis modalities. Methods for both calculating and predicting dialysis drug clearance are reviewed; scaling approaches for predicting dialysis clearance in pediatric patients from data obtained in adults are discussed.
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