Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal

Introducción: La terapia de reemplazo renal (TRR) es una intervención esencial en el manejo de la Lesión Renal Aguda (LRA). En niños en estado crítico está indicada para mejorar el equilibrio hidroelectrolítico, prevenir la acumulación de líquidos y permitir el suministro de medicamentos y nutriente...

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Autores:
Ruano Cifuentes, Ginna Sofía
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/13905
Acceso en línea:
https://hdl.handle.net/20.500.12495/13905
Palabra clave:
Terapia de reemplazo renal
Lesion renal aguda
Cuidado intensivo pediátrico
Mortalidad infantil
Renal replacement therapy
Acute kidney injury
Pediatric critical care
Infant mortality
WS 320
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License
Attribution-NonCommercial-ShareAlike 4.0 International
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network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
dc.title.none.fl_str_mv Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
dc.title.translated.none.fl_str_mv Factors associated with mortality in critical pediatric patients with acute kidney injury treated with renal replacement therapy
title Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
spellingShingle Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
Terapia de reemplazo renal
Lesion renal aguda
Cuidado intensivo pediátrico
Mortalidad infantil
Renal replacement therapy
Acute kidney injury
Pediatric critical care
Infant mortality
WS 320
title_short Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
title_full Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
title_fullStr Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
title_full_unstemmed Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
title_sort Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renal
dc.creator.fl_str_mv Ruano Cifuentes, Ginna Sofía
dc.contributor.advisor.none.fl_str_mv Gonzalez Chaparro, Luz Esthella
dc.contributor.author.none.fl_str_mv Ruano Cifuentes, Ginna Sofía
dc.contributor.orcid.none.fl_str_mv Ruano Cifuentes, Ginna Sofia [0009-0001-5370-754X]
González Chaparro, Luz Estella [0000-0002-5235-9643]
dc.subject.none.fl_str_mv Terapia de reemplazo renal
Lesion renal aguda
Cuidado intensivo pediátrico
Mortalidad infantil
topic Terapia de reemplazo renal
Lesion renal aguda
Cuidado intensivo pediátrico
Mortalidad infantil
Renal replacement therapy
Acute kidney injury
Pediatric critical care
Infant mortality
WS 320
dc.subject.keywords.none.fl_str_mv Renal replacement therapy
Acute kidney injury
Pediatric critical care
Infant mortality
dc.subject.nlm.none.fl_str_mv WS 320
description Introducción: La terapia de reemplazo renal (TRR) es una intervención esencial en el manejo de la Lesión Renal Aguda (LRA). En niños en estado crítico está indicada para mejorar el equilibrio hidroelectrolítico, prevenir la acumulación de líquidos y permitir el suministro de medicamentos y nutrientes. Objetivo: Evaluar los factores asociados a mortalidad en pacientes pediátricos que recibieron TRR en las UCI pediátrica y cardiovascular de la Fundación Cardioinfantil en Bogotá - Colombia entre enero del 2022 y enero del 2024. Materiales y métodos: Estudio observacional, analítico de cohorte retrospectiva. Resultados: Se incluyeron 115 pacientes entre un mes y 17 años ( ̄ 3.4 DE 5.2), predominio masculino (51.3% n=59) con una mortalidad del 41.7%(n=48), el 52.1%(n=25) con TRRC, los factores asociados a mortalidad fueron el Síndrome de disfunción multiorgánica (MODS) (p=0.007), ECMO (p=0.001), el Inicio tardío (48 h desde el ingreso a UCIP) de la TRR (p=0.001), y ECMO en TRR(p=0.001). Conclusión: La mortalidad en niños con LRA tratados con TRR en las unidades de cuidado intensivo pediátrico sigue siendo elevada y se puede asociar con MODS, uso de ECMO e inicio tardío de TRR. Palabras clave: terapia de reemplazo renal, cuidado intensivo pediátrico, lesión renal aguda, mortalidad.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-02-10T15:26:57Z
dc.date.available.none.fl_str_mv 2025-02-10T15:26:57Z
dc.date.issued.none.fl_str_mv 2025-01
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
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identifier_str_mv instname:Universidad El Bosque
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dc.relation.references.none.fl_str_mv 1. Hames DL, Ferguson MA, Kaza AK, Rajagopal S, Thiagarajan RR, Teele SA, et al. Renal replacement therapy in the pediatric cardiac intensive care unit. Journal of Thoracic and Cardiovascular Surgery. 2019 Nov 1;158(5):1446–55.
2. Hames DL, Ferguson MA, Salvin JW. Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy∗. Pediatric Critical Care Medicine. 2019 Nov 1;20(11):1069–77.
3. Ruas AFL, Lébeis GM, de Castro NB, Palmeira VA, Costa LB, Lanza K, et al. Acute kidney injury in pediatrics: an overview focusing on pathophysiology. Pediatric Nephrology. 2022 Sep 1;37(9):2037–52.
4. Bridges BC, Askenazi DJ, Smith J, Goldstein SL. Pediatric renal replacement therapy in the intensive care unit. Blood Purif. 2012 Oct;34(2):138–48.
5. Beltramo F, Dicarlo J, Gruber JB, Taylor T, Totapally BR. Renal Replacement Therapy Modalities in Critically Ill Children∗. Pediatric Critical Care Medicine. 2019 Jan 1;20(1):E1–9
6. Rodríguez-Durán A, Martínez-Urbano J, Laguna-Castro M, Crespo-Montero R. Acute kidney injury in the paediatric patient: An integrative review. Enfermeria Nefrologica. 2022 Jan 1;25(1):11–27.
7. Khandelwal P, McLean N, Menon S. Update on Pediatric Acute Kidney Injury. Pediatr Clin North Am [Internet]. 2022;69(6):1219–38. Available from: https://www.sciencedirect.com/science/article/pii/S003139552200102X
8. Chang JW, Jeng MJ, Yang LY, Chen TJ, Chiang SC, Soong WJ, et al. The epidemiology and prognostic factors of mortality in critically ill children with acute kidney injury in Taiwan. Kidney Int. 2015 Mar 1;87(3):632–9.
9. Del M, Suárez P, Fernández-Sarmiento J, Esthella González L, Rico MP, Sebastián Barajas J, et al. Evaluation of the Renal Angina Index to Predict the Development of Acute Kidney Injury in Children With Sepsis Who Live in Middle-Income Countries [Internet]. 2023. Available from: www.pec-online.com
10. Ricci Z, Romagnoli S, Villa G, Ronco C. Modality and dosing of acute renal replacement therapy. Minerva Urologica e Nefrologica. 2016;68(1):78–86.
11. Sanderson KR, Harshman LA. Renal replacement therapies for infants and children in the ICU. Vol. 32, Current opinion in pediatrics. NLM (Medline); 2020. p. 360–6.
12. Voraruth C, Pirojsakul K, Saisawat P, Chantarogh S, Tangnararatchakit K. Clinical Outcomes of Renal Replacement Therapy in Pediatric Acute Kidney Injury: A 10-Year Retrospective Observational Study. Glob Pediatr Health. 2022 Jan 1;9.
13. Çeleğen K, Çeleğen M. A retrospective analysis: the outcome of renal replacement therapies in critically ill children. Rev Assoc Med Bras. 2023;69(6).
14. Aygun F. Evaluation of Continuous Renal Replacement Therapy and Risk Factors in the Pediatric Intensive Care Unit [Internet]. Vol. 31, Saudi J Kidney Dis Transpl. 2020. Available from: http://www.sjkdt.org
15. Banigan MA, Keim G, Traynor D, Yehya N, Lindell RB, Fitzgerald JC. Association of continuous kidney replacement therapy timing and mortality in critically ill children. Pediatric Nephrology. 2024 Jul 1;39(7):2217–26.
16. Demirkol D. Continuous Renal Replacement Therapy in Critically Ill Children. Vol. 57, Turkish Archives of Pediatrics. AVES; 2022. p. 489–97.
17. Pekkucuksen NT, Akcan Arikan A, Swartz SJ, Srivaths P, Angelo JR. Characteristics and Clinical Outcomes of Prolonged Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients. Pediatric Critical Care Medicine. 2020 Jun 1;21(6):571–7.
18. Chegondi M, Devarashetty S, Balakumar N, Sendi P, Totapally BR. The need for hemodialysis is associated with increased mortality in mechanically ventilated children: a propensity score-matched outcome study. Available from: https://doi.org/10.1007/s00467-020-04703-3
19. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL. Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults. New England Journal of Medicine. 2017 Jan 5;376(1):11–20.
20. Plaud A, Siddiqui Sahar S, Arikan AA. Fluid Overload and Kidney Injury Score. In: Advances in Critical Care Pediatric Nephrology: Point of Care Ultrasound and Diagnostics. Springer Singapore; 2021. p. 93–102.
21. Duyu M. Clinical Features and Risk Factors Associated with Mortality in Critically ill Children Requiring Continuous Renal Replacement Therapy. 2020; Available from: https://doi.org/10.21203/rs.3.rs-40243/v1
22. Menon S, Starr MC, Zang H, Collins M, Damian MA, Fuhrman D, et al. Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study. Pediatric Nephrology. 2024;
23. Assadi F, Sharbaf FG. CRRT Prescription. In: Pediatric Continuous Renal Replacement Therapy. Springer International Publishing; 2016. p. 71–97.
24. Foti L, Villa G, Romagnoli S, Ricci Z. Acute kidney injury and extracorporeal membrane oxygenation: Review on multiple organ support options. Vol. 14, International Journal of Nephrology and Renovascular Disease. Dove Medical Press Ltd; 2021. p. 321–9
25. Gu M, Mei XL, Zhao YN. A review on extracorporeal membrane oxygenation and kidney injury. Vol. 35, Journal of Biochemical and Molecular Toxicology. John Wiley and Sons Inc; 2021.
26. Selewski DT, Wille KM. Continuous renal replacement therapy in patients treated with extracorporeal membrane oxygenation. Semin Dial. 2021 Nov 1;34(6):537–49.
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institution Universidad El Bosque
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spelling Gonzalez Chaparro, Luz EsthellaRuano Cifuentes, Ginna SofíaRuano Cifuentes, Ginna Sofia [0009-0001-5370-754X]González Chaparro, Luz Estella [0000-0002-5235-9643]2025-02-10T15:26:57Z2025-02-10T15:26:57Z2025-01https://hdl.handle.net/20.500.12495/13905instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coIntroducción: La terapia de reemplazo renal (TRR) es una intervención esencial en el manejo de la Lesión Renal Aguda (LRA). En niños en estado crítico está indicada para mejorar el equilibrio hidroelectrolítico, prevenir la acumulación de líquidos y permitir el suministro de medicamentos y nutrientes. Objetivo: Evaluar los factores asociados a mortalidad en pacientes pediátricos que recibieron TRR en las UCI pediátrica y cardiovascular de la Fundación Cardioinfantil en Bogotá - Colombia entre enero del 2022 y enero del 2024. Materiales y métodos: Estudio observacional, analítico de cohorte retrospectiva. Resultados: Se incluyeron 115 pacientes entre un mes y 17 años ( ̄ 3.4 DE 5.2), predominio masculino (51.3% n=59) con una mortalidad del 41.7%(n=48), el 52.1%(n=25) con TRRC, los factores asociados a mortalidad fueron el Síndrome de disfunción multiorgánica (MODS) (p=0.007), ECMO (p=0.001), el Inicio tardío (48 h desde el ingreso a UCIP) de la TRR (p=0.001), y ECMO en TRR(p=0.001). Conclusión: La mortalidad en niños con LRA tratados con TRR en las unidades de cuidado intensivo pediátrico sigue siendo elevada y se puede asociar con MODS, uso de ECMO e inicio tardío de TRR. Palabras clave: terapia de reemplazo renal, cuidado intensivo pediátrico, lesión renal aguda, mortalidad.Fundacion CardioinfantilEspecialista en Nefrología PediátricaEspecializaciónIntroduction: Renal replacement therapy (RRT) is an essential intervention in the management of Acute Kidney Injury (AKI). In critically ill children, it is indicated to improve hydroelectrolytic balance, prevent fluid accumulation, and allow the delivery of medications and nutrients. Objective: To evaluate the factors associated with mortality in pediatric patients who received RRT in the pediatric and cardiovascular ICUs of the Cardioinfantil Foundation in Bogotá - Colombia between January 2022 and January 2024. Materials and methods: Observational, analytical, retrospective cohort study. Results: 115 patients between one month and 17 years ( ̄ 3.4 SD 5.2) were included, male predominance (51.3% n=59) with a mortality of 41.7% (n=48), 52.1% (n=25) with CRRT, the factors associated with mortality were the multiple organ dysfunction syndrome (MODS) (p=0.007), ECMO (p=0.001), late initiation (48 h from admission to ICU) of RRT (p=0.001), and ECMO in RRT (p=0.001). Conclusion: Mortality in children with AKI treated with RRT in pediatric intensive care units remains high and can be associated with MODS, ECMO use and late initiation of RRT. Keywords: Renal replacement therapy, pediatric critical care, acute kidney injury, mortality.application/pdfAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Terapia de reemplazo renalLesion renal agudaCuidado intensivo pediátricoMortalidad infantilRenal replacement therapyAcute kidney injuryPediatric critical careInfant mortalityWS 320Factores asociados a mortalidad en niños críticos con lesión renal aguda que reciben terapia de remplazo renalFactors associated with mortality in critical pediatric patients with acute kidney injury treated with renal replacement therapyEspecialización en Nefrología PediátricaUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Hames DL, Ferguson MA, Kaza AK, Rajagopal S, Thiagarajan RR, Teele SA, et al. Renal replacement therapy in the pediatric cardiac intensive care unit. Journal of Thoracic and Cardiovascular Surgery. 2019 Nov 1;158(5):1446–55.2. Hames DL, Ferguson MA, Salvin JW. Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy∗. Pediatric Critical Care Medicine. 2019 Nov 1;20(11):1069–77.3. Ruas AFL, Lébeis GM, de Castro NB, Palmeira VA, Costa LB, Lanza K, et al. Acute kidney injury in pediatrics: an overview focusing on pathophysiology. Pediatric Nephrology. 2022 Sep 1;37(9):2037–52.4. Bridges BC, Askenazi DJ, Smith J, Goldstein SL. Pediatric renal replacement therapy in the intensive care unit. Blood Purif. 2012 Oct;34(2):138–48.5. Beltramo F, Dicarlo J, Gruber JB, Taylor T, Totapally BR. Renal Replacement Therapy Modalities in Critically Ill Children∗. Pediatric Critical Care Medicine. 2019 Jan 1;20(1):E1–96. Rodríguez-Durán A, Martínez-Urbano J, Laguna-Castro M, Crespo-Montero R. Acute kidney injury in the paediatric patient: An integrative review. Enfermeria Nefrologica. 2022 Jan 1;25(1):11–27.7. Khandelwal P, McLean N, Menon S. Update on Pediatric Acute Kidney Injury. Pediatr Clin North Am [Internet]. 2022;69(6):1219–38. Available from: https://www.sciencedirect.com/science/article/pii/S003139552200102X8. Chang JW, Jeng MJ, Yang LY, Chen TJ, Chiang SC, Soong WJ, et al. The epidemiology and prognostic factors of mortality in critically ill children with acute kidney injury in Taiwan. Kidney Int. 2015 Mar 1;87(3):632–9.9. Del M, Suárez P, Fernández-Sarmiento J, Esthella González L, Rico MP, Sebastián Barajas J, et al. Evaluation of the Renal Angina Index to Predict the Development of Acute Kidney Injury in Children With Sepsis Who Live in Middle-Income Countries [Internet]. 2023. Available from: www.pec-online.com10. Ricci Z, Romagnoli S, Villa G, Ronco C. Modality and dosing of acute renal replacement therapy. Minerva Urologica e Nefrologica. 2016;68(1):78–86.11. Sanderson KR, Harshman LA. Renal replacement therapies for infants and children in the ICU. Vol. 32, Current opinion in pediatrics. NLM (Medline); 2020. p. 360–6.12. Voraruth C, Pirojsakul K, Saisawat P, Chantarogh S, Tangnararatchakit K. Clinical Outcomes of Renal Replacement Therapy in Pediatric Acute Kidney Injury: A 10-Year Retrospective Observational Study. Glob Pediatr Health. 2022 Jan 1;9.13. Çeleğen K, Çeleğen M. A retrospective analysis: the outcome of renal replacement therapies in critically ill children. Rev Assoc Med Bras. 2023;69(6).14. Aygun F. Evaluation of Continuous Renal Replacement Therapy and Risk Factors in the Pediatric Intensive Care Unit [Internet]. Vol. 31, Saudi J Kidney Dis Transpl. 2020. Available from: http://www.sjkdt.org15. Banigan MA, Keim G, Traynor D, Yehya N, Lindell RB, Fitzgerald JC. Association of continuous kidney replacement therapy timing and mortality in critically ill children. Pediatric Nephrology. 2024 Jul 1;39(7):2217–26.16. Demirkol D. Continuous Renal Replacement Therapy in Critically Ill Children. Vol. 57, Turkish Archives of Pediatrics. AVES; 2022. p. 489–97.17. Pekkucuksen NT, Akcan Arikan A, Swartz SJ, Srivaths P, Angelo JR. Characteristics and Clinical Outcomes of Prolonged Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients. Pediatric Critical Care Medicine. 2020 Jun 1;21(6):571–7.18. Chegondi M, Devarashetty S, Balakumar N, Sendi P, Totapally BR. The need for hemodialysis is associated with increased mortality in mechanically ventilated children: a propensity score-matched outcome study. Available from: https://doi.org/10.1007/s00467-020-04703-319. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL. Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults. New England Journal of Medicine. 2017 Jan 5;376(1):11–20.20. Plaud A, Siddiqui Sahar S, Arikan AA. Fluid Overload and Kidney Injury Score. In: Advances in Critical Care Pediatric Nephrology: Point of Care Ultrasound and Diagnostics. Springer Singapore; 2021. p. 93–102.21. Duyu M. Clinical Features and Risk Factors Associated with Mortality in Critically ill Children Requiring Continuous Renal Replacement Therapy. 2020; Available from: https://doi.org/10.21203/rs.3.rs-40243/v122. Menon S, Starr MC, Zang H, Collins M, Damian MA, Fuhrman D, et al. Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study. Pediatric Nephrology. 2024;23. Assadi F, Sharbaf FG. CRRT Prescription. In: Pediatric Continuous Renal Replacement Therapy. Springer International Publishing; 2016. p. 71–97.24. Foti L, Villa G, Romagnoli S, Ricci Z. Acute kidney injury and extracorporeal membrane oxygenation: Review on multiple organ support options. Vol. 14, International Journal of Nephrology and Renovascular Disease. Dove Medical Press Ltd; 2021. p. 321–925. Gu M, Mei XL, Zhao YN. A review on extracorporeal membrane oxygenation and kidney injury. Vol. 35, Journal of Biochemical and Molecular Toxicology. John Wiley and Sons Inc; 2021.26. Selewski DT, Wille KM. Continuous renal replacement therapy in patients treated with extracorporeal membrane oxygenation. 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