Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry

Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influenc...
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Autor*in:	Deja, Anna [verfasserIn] Guzzo, Isabella [verfasserIn] Cappoli, Andrea [verfasserIn] Labbadia, Raffaella [verfasserIn] Bayazit, Aysun Karabay [verfasserIn] Yildizdas, Dincer [verfasserIn] Schmitt, Claus Peter [verfasserIn] Tkaczyk, Marcin [verfasserIn] Cvetkovic, Mirjana [verfasserIn] Kostic, Mirjana [verfasserIn] Hayes, Wesley [verfasserIn] Shroff, Rukshana [verfasserIn] Jankauskiene, Augustina [verfasserIn] Virsilas, Ernestas [verfasserIn] Longo, Germana [verfasserIn] Vidal, Enrico [verfasserIn] Mir, Sevgi [verfasserIn] Bulut, Ipek Kaplan [verfasserIn] Pasini, Andrea [verfasserIn] Paglialonga, Fabio [verfasserIn] Montini, Giovanni [verfasserIn] Yilmaz, Ebru [verfasserIn] Costa, Liane Correia [verfasserIn] Teixeira, Ana [verfasserIn] Schaefer, Franz [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	Acute kidney injury Continuous kidney replacement therapy Circuit lifetime Regional citrate anticoagulation

Anmerkung:	© The Author(s) 2024

Übergeordnetes Werk:	Enthalten in: Pediatric nephrology - Springer Berlin Heidelberg, 1987, 39(2024), 11 vom: 18. Juli, Seite 3353-3362
Übergeordnetes Werk:	volume:39 ; year:2024 ; number:11 ; day:18 ; month:07 ; pages:3353-3362

Links:	Volltext

DOI / URN:	10.1007/s00467-024-06459-6

Katalog-ID:	SPR057379076

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245	1	0	\|a Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
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520			\|a Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information
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700	1		\|a Tkaczyk, Marcin \|e verfasserin \|4 aut
700	1		\|a Cvetkovic, Mirjana \|e verfasserin \|4 aut
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700	1		\|a Bulut, Ipek Kaplan \|e verfasserin \|4 aut
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700	1		\|a Teixeira, Ana \|e verfasserin \|4 aut
700	1		\|a Schaefer, Franz \|e verfasserin \|4 aut
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allfields	10.1007/s00467-024-06459-6 doi (DE-627)SPR057379076 (SPR)s00467-024-06459-6-e DE-627 ger DE-627 rakwb eng 610 VZ 44.88 bkl 44.67 bkl Deja, Anna verfasserin (orcid)0000-0002-9901-4140 aut Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213 Guzzo, Isabella verfasserin aut Cappoli, Andrea verfasserin aut Labbadia, Raffaella verfasserin aut Bayazit, Aysun Karabay verfasserin aut Yildizdas, Dincer verfasserin aut Schmitt, Claus Peter verfasserin aut Tkaczyk, Marcin verfasserin aut Cvetkovic, Mirjana verfasserin aut Kostic, Mirjana verfasserin aut Hayes, Wesley verfasserin aut Shroff, Rukshana verfasserin aut Jankauskiene, Augustina verfasserin aut Virsilas, Ernestas verfasserin aut Longo, Germana verfasserin aut Vidal, Enrico verfasserin aut Mir, Sevgi verfasserin aut Bulut, Ipek Kaplan verfasserin aut Pasini, Andrea verfasserin aut Paglialonga, Fabio verfasserin aut Montini, Giovanni verfasserin aut Yilmaz, Ebru verfasserin aut Costa, Liane Correia verfasserin aut Teixeira, Ana verfasserin aut Schaefer, Franz verfasserin aut Enthalten in Pediatric nephrology Springer Berlin Heidelberg, 1987 39(2024), 11 vom: 18. Juli, Seite 3353-3362 (DE-627)254638872 (DE-600)1463004-7 1432-198X nnns volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362 https://dx.doi.org/10.1007/s00467-024-06459-6 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.88 VZ 44.67 VZ AR 39 2024 11 18 07 3353-3362
spelling	10.1007/s00467-024-06459-6 doi (DE-627)SPR057379076 (SPR)s00467-024-06459-6-e DE-627 ger DE-627 rakwb eng 610 VZ 44.88 bkl 44.67 bkl Deja, Anna verfasserin (orcid)0000-0002-9901-4140 aut Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213 Guzzo, Isabella verfasserin aut Cappoli, Andrea verfasserin aut Labbadia, Raffaella verfasserin aut Bayazit, Aysun Karabay verfasserin aut Yildizdas, Dincer verfasserin aut Schmitt, Claus Peter verfasserin aut Tkaczyk, Marcin verfasserin aut Cvetkovic, Mirjana verfasserin aut Kostic, Mirjana verfasserin aut Hayes, Wesley verfasserin aut Shroff, Rukshana verfasserin aut Jankauskiene, Augustina verfasserin aut Virsilas, Ernestas verfasserin aut Longo, Germana verfasserin aut Vidal, Enrico verfasserin aut Mir, Sevgi verfasserin aut Bulut, Ipek Kaplan verfasserin aut Pasini, Andrea verfasserin aut Paglialonga, Fabio verfasserin aut Montini, Giovanni verfasserin aut Yilmaz, Ebru verfasserin aut Costa, Liane Correia verfasserin aut Teixeira, Ana verfasserin aut Schaefer, Franz verfasserin aut Enthalten in Pediatric nephrology Springer Berlin Heidelberg, 1987 39(2024), 11 vom: 18. Juli, Seite 3353-3362 (DE-627)254638872 (DE-600)1463004-7 1432-198X nnns volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362 https://dx.doi.org/10.1007/s00467-024-06459-6 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.88 VZ 44.67 VZ AR 39 2024 11 18 07 3353-3362
allfields_unstemmed	10.1007/s00467-024-06459-6 doi (DE-627)SPR057379076 (SPR)s00467-024-06459-6-e DE-627 ger DE-627 rakwb eng 610 VZ 44.88 bkl 44.67 bkl Deja, Anna verfasserin (orcid)0000-0002-9901-4140 aut Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213 Guzzo, Isabella verfasserin aut Cappoli, Andrea verfasserin aut Labbadia, Raffaella verfasserin aut Bayazit, Aysun Karabay verfasserin aut Yildizdas, Dincer verfasserin aut Schmitt, Claus Peter verfasserin aut Tkaczyk, Marcin verfasserin aut Cvetkovic, Mirjana verfasserin aut Kostic, Mirjana verfasserin aut Hayes, Wesley verfasserin aut Shroff, Rukshana verfasserin aut Jankauskiene, Augustina verfasserin aut Virsilas, Ernestas verfasserin aut Longo, Germana verfasserin aut Vidal, Enrico verfasserin aut Mir, Sevgi verfasserin aut Bulut, Ipek Kaplan verfasserin aut Pasini, Andrea verfasserin aut Paglialonga, Fabio verfasserin aut Montini, Giovanni verfasserin aut Yilmaz, Ebru verfasserin aut Costa, Liane Correia verfasserin aut Teixeira, Ana verfasserin aut Schaefer, Franz verfasserin aut Enthalten in Pediatric nephrology Springer Berlin Heidelberg, 1987 39(2024), 11 vom: 18. Juli, Seite 3353-3362 (DE-627)254638872 (DE-600)1463004-7 1432-198X nnns volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362 https://dx.doi.org/10.1007/s00467-024-06459-6 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.88 VZ 44.67 VZ AR 39 2024 11 18 07 3353-3362
allfieldsGer	10.1007/s00467-024-06459-6 doi (DE-627)SPR057379076 (SPR)s00467-024-06459-6-e DE-627 ger DE-627 rakwb eng 610 VZ 44.88 bkl 44.67 bkl Deja, Anna verfasserin (orcid)0000-0002-9901-4140 aut Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213 Guzzo, Isabella verfasserin aut Cappoli, Andrea verfasserin aut Labbadia, Raffaella verfasserin aut Bayazit, Aysun Karabay verfasserin aut Yildizdas, Dincer verfasserin aut Schmitt, Claus Peter verfasserin aut Tkaczyk, Marcin verfasserin aut Cvetkovic, Mirjana verfasserin aut Kostic, Mirjana verfasserin aut Hayes, Wesley verfasserin aut Shroff, Rukshana verfasserin aut Jankauskiene, Augustina verfasserin aut Virsilas, Ernestas verfasserin aut Longo, Germana verfasserin aut Vidal, Enrico verfasserin aut Mir, Sevgi verfasserin aut Bulut, Ipek Kaplan verfasserin aut Pasini, Andrea verfasserin aut Paglialonga, Fabio verfasserin aut Montini, Giovanni verfasserin aut Yilmaz, Ebru verfasserin aut Costa, Liane Correia verfasserin aut Teixeira, Ana verfasserin aut Schaefer, Franz verfasserin aut Enthalten in Pediatric nephrology Springer Berlin Heidelberg, 1987 39(2024), 11 vom: 18. Juli, Seite 3353-3362 (DE-627)254638872 (DE-600)1463004-7 1432-198X nnns volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362 https://dx.doi.org/10.1007/s00467-024-06459-6 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.88 VZ 44.67 VZ AR 39 2024 11 18 07 3353-3362
allfieldsSound	10.1007/s00467-024-06459-6 doi (DE-627)SPR057379076 (SPR)s00467-024-06459-6-e DE-627 ger DE-627 rakwb eng 610 VZ 44.88 bkl 44.67 bkl Deja, Anna verfasserin (orcid)0000-0002-9901-4140 aut Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213 Guzzo, Isabella verfasserin aut Cappoli, Andrea verfasserin aut Labbadia, Raffaella verfasserin aut Bayazit, Aysun Karabay verfasserin aut Yildizdas, Dincer verfasserin aut Schmitt, Claus Peter verfasserin aut Tkaczyk, Marcin verfasserin aut Cvetkovic, Mirjana verfasserin aut Kostic, Mirjana verfasserin aut Hayes, Wesley verfasserin aut Shroff, Rukshana verfasserin aut Jankauskiene, Augustina verfasserin aut Virsilas, Ernestas verfasserin aut Longo, Germana verfasserin aut Vidal, Enrico verfasserin aut Mir, Sevgi verfasserin aut Bulut, Ipek Kaplan verfasserin aut Pasini, Andrea verfasserin aut Paglialonga, Fabio verfasserin aut Montini, Giovanni verfasserin aut Yilmaz, Ebru verfasserin aut Costa, Liane Correia verfasserin aut Teixeira, Ana verfasserin aut Schaefer, Franz verfasserin aut Enthalten in Pediatric nephrology Springer Berlin Heidelberg, 1987 39(2024), 11 vom: 18. Juli, Seite 3353-3362 (DE-627)254638872 (DE-600)1463004-7 1432-198X nnns volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362 https://dx.doi.org/10.1007/s00467-024-06459-6 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.88 VZ 44.67 VZ AR 39 2024 11 18 07 3353-3362
language	English
source	Enthalten in Pediatric nephrology 39(2024), 11 vom: 18. Juli, Seite 3353-3362 volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362
sourceStr	Enthalten in Pediatric nephrology 39(2024), 11 vom: 18. Juli, Seite 3353-3362 volume:39 year:2024 number:11 day:18 month:07 pages:3353-3362
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Acute kidney injury Continuous kidney replacement therapy Circuit lifetime Regional citrate anticoagulation
dewey-raw	610
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container_title	Pediatric nephrology
authorswithroles_txt_mv	Deja, Anna @@aut@@ Guzzo, Isabella @@aut@@ Cappoli, Andrea @@aut@@ Labbadia, Raffaella @@aut@@ Bayazit, Aysun Karabay @@aut@@ Yildizdas, Dincer @@aut@@ Schmitt, Claus Peter @@aut@@ Tkaczyk, Marcin @@aut@@ Cvetkovic, Mirjana @@aut@@ Kostic, Mirjana @@aut@@ Hayes, Wesley @@aut@@ Shroff, Rukshana @@aut@@ Jankauskiene, Augustina @@aut@@ Virsilas, Ernestas @@aut@@ Longo, Germana @@aut@@ Vidal, Enrico @@aut@@ Mir, Sevgi @@aut@@ Bulut, Ipek Kaplan @@aut@@ Pasini, Andrea @@aut@@ Paglialonga, Fabio @@aut@@ Montini, Giovanni @@aut@@ Yilmaz, Ebru @@aut@@ Costa, Liane Correia @@aut@@ Teixeira, Ana @@aut@@ Schaefer, Franz @@aut@@
publishDateDaySort_date	2024-07-18T00:00:00Z
hierarchy_top_id	254638872
dewey-sort	3610
id	SPR057379076
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR057379076</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240920064707.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240920s2024 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00467-024-06459-6</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR057379076</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00467-024-06459-6-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.88</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.67</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Deja, Anna</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0002-9901-4140</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2024</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. 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author	Deja, Anna
spellingShingle	Deja, Anna ddc 610 bkl 44.88 bkl 44.67 misc Acute kidney injury misc Continuous kidney replacement therapy misc Circuit lifetime misc Regional citrate anticoagulation Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
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topic_title	610 VZ 44.88 bkl 44.67 bkl Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry Acute kidney injury (dpeaa)DE-He213 Continuous kidney replacement therapy (dpeaa)DE-He213 Circuit lifetime (dpeaa)DE-He213 Regional citrate anticoagulation (dpeaa)DE-He213
topic	ddc 610 bkl 44.88 bkl 44.67 misc Acute kidney injury misc Continuous kidney replacement therapy misc Circuit lifetime misc Regional citrate anticoagulation
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title	Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
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title_full	Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
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author_browse	Deja, Anna Guzzo, Isabella Cappoli, Andrea Labbadia, Raffaella Bayazit, Aysun Karabay Yildizdas, Dincer Schmitt, Claus Peter Tkaczyk, Marcin Cvetkovic, Mirjana Kostic, Mirjana Hayes, Wesley Shroff, Rukshana Jankauskiene, Augustina Virsilas, Ernestas Longo, Germana Vidal, Enrico Mir, Sevgi Bulut, Ipek Kaplan Pasini, Andrea Paglialonga, Fabio Montini, Giovanni Yilmaz, Ebru Costa, Liane Correia Teixeira, Ana Schaefer, Franz
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title_sort	factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the eurakid registry
title_auth	Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
abstract	Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information © The Author(s) 2024
abstractGer	Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information © The Author(s) 2024
abstract_unstemmed	Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications. Results The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications. Conclusion Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information © The Author(s) 2024
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title_short	Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
url	https://dx.doi.org/10.1007/s00467-024-06459-6
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author2	Guzzo, Isabella Cappoli, Andrea Labbadia, Raffaella Bayazit, Aysun Karabay Yildizdas, Dincer Schmitt, Claus Peter Tkaczyk, Marcin Cvetkovic, Mirjana Kostic, Mirjana Hayes, Wesley Shroff, Rukshana Jankauskiene, Augustina Virsilas, Ernestas Longo, Germana Vidal, Enrico Mir, Sevgi Bulut, Ipek Kaplan Pasini, Andrea Paglialonga, Fabio Montini, Giovanni Yilmaz, Ebru Costa, Liane Correia Teixeira, Ana Schaefer, Franz
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Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry

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