ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
liver, 51.6% (31/60) for heart and 40.9%
(9/22) for lung graft recipients,
respectively. Mean serum creatinine at
the end of the study period (30 days) was
2.34 mg% (1,97 mg% in liver, 2,26
mg% in heart and 2,89 mg% in lung
graft recipients, respectively).
Our 10-year retrospective analysis
revealed an increased incidence of AKI
in the NRSOT population. The main
cause of AKI was sepsis which was
associated with an increase of mortality
and with an impairment of renal function
that may be responsible for the
progression toward CKD.
50. Case Report of Renal Replacement
Therapy in a 1-year old patient
with AKI
Gastón Castillo, Magda Cepeda, Jaime
Restrepo Fundación Valle del Lili
Renal replacement therapy in children is
a rare event, but with important
implications for morbidity and mortality
in this age group. Although the
incidence of children with kidney failure
is relatively low and patients requiring
renal replacement therapy are usually
few in these, has been recognized the
significant positive impact on early
recognition of children who require and
implement of adequate therapy.
According to the annual report of the
UK Renal Registry, during 2009 there
were 751 children with established renal
injury receiving renal replacement
therapy. We report a case of a patient
who required renal replacement therapy
secondary to a procedure-related multiorgan
failure.
The patient was referred <strong>from</strong> a
peripheral center of care with a diagnosis
of septic shock of abdominal origin,
multiorgan failure, acute renal injury,
post- laparotomy for correction of
intestinal mal-rotation, intestinal
obstruction and release of congenital
constricting bands and syndrome postresuscitation.
The patient was
hospitalized in the Pediatric Intensive
Care Unit (PICU). The principal clinical
of the patient consisted in 6 days of
intestinal obstruction, secondary to
constricting bands and intestinal malrotation.
In the course of corrective
surgery, the patient presented cardiorespiratory
failure accompanied by renal
failure, and was referred to institution.
To acute renal injury management we
used renal replacement therapy with
continuous veno-venous hemofiltration
(CVVHF) for five days, then started
continuous infusion of furosemide in
which there was no improvement, which
required restarting CVVHF for 18 days
and hemodiafiltration with pump flow to
100ml/min with fluid loss of 150 ml/h.
Renal function recovery was obtained
after 30-days of management. As a
related complication, blow up of catheter
and filter plugging occurred.
After a 30-days hospitalization, the
patient was discharged with additional
diagnosis of postoperative of severe
pneumonia and acute respiratory distress
syndrome, septic shock refractory to
inotropic fungemia resolved, myocardial
dysfunction, renal dysfunction and acute
renal injury.
Acute renal injury is a condition that
quickly complicated pediatric patient,
sepsis remains the leading cause of the
complication reported in multiple series.
Previous reports have shown the
advantage of starting early RRT patients
with a significant favorable impact in
patients with sepsis and multi-organic
failure.
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