Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Continuous Renal Replacement Therapy in Infants and Neonates

신생아와 영아의 지속적 신대체 요법

  • Kim, Seong Heon (Department of Pediatrics, Pusan National University Children's Hospital, Pusan National School of Medicine) ;
  • Shin, Jae Il (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine)
  • 김성헌 (부산대학교 의학전문대학원 소아청소년과학교실) ;
  • 신재일 (연세대학교 의과대학 소아과학교실)
  • Received : 2014.03.14
  • Accepted : 2014.04.11
  • Published : 2014.04.30
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Abstract

Continuous renal replacement therapy (CRRT) has become the preferred dialysis modality to support critically ill children with acute kidney injury. As CRRT technology and clinical practice advances, experiences using CRRT on small infants and neonates have increased. In neonates with hyperammonemia or acute kidney injury during extracorporeal membrane oxygenation (ECMO) therapy, CRRT can be a safe and effective technique. However, there are many limitations of CRRT in neonates, including vascular access, bleeding complications, and lack of neonatespecific devices. This review discusses the basic principles of CRRT and the special considerations when using this technique in neonates and infants.

지속적 신 대체 요법(CRRT)은 급성 신손상이 있는 중증 소아의 치료로 점차 사용이 늘어나고 있으며 CRRT의 기술과 실제 사용법이 발달하면서 작은 영아나 신생아에서도 그 사용이 조금씩 늘어나고 있다. 고암모니아혈증이나 체외막산소화 장치(ECMO) 치료 중에 발생한 급성 신손상 등의 경우 CRRT가 안전하고 효과적인 치료가 될 수 있으나, 혈관 접근이나 출혈 그리고 신생아 전용 CRRT device의 부재로 인한 여러 가지 제한점이 있다. 이 종설에서는 기본적인 CRRT의 원리를 알아보고 신생아와 영아에서 특별히 고려해야 할 사항들에 대해 알아보고자 한다.

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References

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