Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is a treatment used to support children with kidney failure and/or fluid overload who are too sick for traditional dialysis. A specialized machine is used to pump blood from a large intravenous (IV) catheter in the patient, through an artificial kidney (hemofilter) that removes excess fluid and waste products, and then return the “clean” blood to the patient.

Why do Children Need CRRT?

There are several diseases that can cause acute kidney failure. In some cases, the child’s kidneys may not be able to remove the normal waste products that build up in the blood or they may not be able to remove fluid which can lead to severe swelling of the body and organs. A few of the conditions that may benefit from CRRT are listed below.

  • Acute Tubular Necrosis
  • Hemolytic Uremic Syndrome
  • Sepsis
  • Tumor Lysis Syndrome
  • Severe Acidosis
  • Liver Failure
  • Rhabdomyolysis

Who Cares for Children on CRRT?

Children who need CRRT will be cared for in the Pediatric Intensive Care Unit (PICU) at University Hospital. A specially trained team of clinicians will work together to provide the best possible care for these very fragile patients. In addition to the nurses, respiratory therapists, child life specialists, social workers and other support staff who are always available to assist in the care of pediatric patients, the following individuals are responsible for the care of patients receiving continuous renal replacement therapy:

  • Pediatric Intensivist – The pediatric intensivist is a pediatrician who has completed additional training in order to care for very sick babies and children. This will be the child’s primary doctor while they are in the Intensive Care Unit.
  • Pediatric Nephrologist – A nephrologist is a doctor who specializes in care of patients with diseases of the kidney.  The pediatric nephrologist will consult with the pediatric intensivists in order to customize the treatment to the specific needs of each patient.
  • Pediatric Critical Care Nurse – The nurses in the PICU are skilled in all aspects of caring for very sick children.  They also have additional training in order to run the CRRT machine and make adjustments based on goals that the doctor has set. A pediatric critical care nurse will remain at the bedside 24 hours a day for all patients on CRRT.
  • Advanced Technology Specialist (ATS) – The ATS is responsible for setting up the CRRT machine and advanced trouble-shooting during the treatment. There is an ATS on-call 24 hours a day to assist with any concerns related to CRRT.