A study of the ability to achieve negative water balance in children undergoing continuous renal replacement therapy (CRRT) and its possible relation to mortality.

Not Applicable

Completed

• Conditions: Critically ill children; Acute kidney injury; Renal and Urogenital - Other renal and urogenital disorders

• Registration Number: ACTRN12617000753358
• Lead Sponsor: Karolinska University Hospital

Brief Summary

Primary research question: to investigate if the ability to achieve a negative fluid balance during the first 3 days using continuous dialysis was associated with mortality and other key outcomes in children with multiple organ failure (MOF). Background: Critically ill children with MOF are subjected to high mortality which further increase if substantial fluid overload (FO) is present. Participant characteristics: Critically ill children (0-18 years) with 3 or more organs failing, including severe acute kidney injury requiring dialysis. Median age was 4 months. Key results: Mortality during intensive care was 29 %. Survivors had less FO compared to non-survivors on dialysis initiation, 15 and 24 % respectively. The mortality was lower in patient where a negative fluid balance was achieved, as compared to patients who had further fluid accumulation, 12 vs 86 % respectively. Limitations: The main limitation is the retrospective design of the study. The results need to be verified in prospective studies.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2017-05-22
• Study Completion: 2017-09-30
• Last Update Posted: 16 January 2023

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 64

Inclusion Criteria

Critically ill children (age newborns up to 18 year) subjected to acute kidney injury and undergoing continuous renal replacement therapy (CRRT).

Exclusion Criteria

All critically ill children not undergoing CRRT

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Occurrence of water imbalance defined as inability to achieve cumulative negative water balance within 72 hours after CRRT initiation as reported in medical records and its possible association with increased mortality. [Ability to acheive negative water balance within 72 hours after CRRT initiation (yes or no).<br><br>];Mortality[Mortality occurring during PICU stay.]

Secondary Outcome Measures

Name	Time	Method
Fluid overload (FO) defined as cumulative FO from admission until the initiation of CRRT. FO will be calculated as: FO % = ml fluid in - fluid out from admission to the PICU divided by admission weight.<br><br>[FO occurring from PICU admission until CRRT initiation. ];Circuit life span defined as the median survival time of dialysis filter[Circuit life span during CRRT.];The severity of illness (6 organ failures: neurological, respiratory, circulatory, renal, immunological and liver) measured at admission to the PICU by medical records[At admission to the PICU.]