Publication Date
4-1-2023
Journal
Critical Care Explorations
DOI
10.1097/CCE.0000000000000891
PMID
37066071
PMCID
PMC10097539
PubMedCentral® Posted Date
4-11-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
acute kidney injury, continuous kidney replacement therapy, thrombocytopenia, thrombocytopenia-associated multiple organ failure, thrombotic microangiopathy
Abstract
Therapeutic plasma exchange (TPE) has been shown to improve organ dysfunction and survival in patients with thrombotic microangiopathy and thrombocytopenia associated with multiple organ failure. There are no known therapies for the prevention of major adverse kidney events after continuous kidney replacement therapy (CKRT). The primary objective of this study was to evaluate the effect of TPE on the rate of adverse kidney events in children and young adults with thrombocytopenia at the time of CKRT initiation.
DESIGN: Retrospective cohort.
SETTING: Two large quaternary care pediatric hospitals.
PATIENTS: All patients less than or equal to 26 years old who received CKRT between 2014 and 2020.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: We defined thrombocytopenia as a platelet count less than or equal to 100,000 (cell/mm
CONCLUSIONS: Thrombocytopenia is common in children and young adults at CKRT initiation and is associated with increased MAKE90. In this subset of patients, our data show benefit of TPE in reducing the rate of MAKE90.