Complications of continuous renal replacement therapy in children: are all created equal?

Continuous renal replacement therapy (CRRT) in pediatric acute kidney dysfunction has evolved in recent decades; however, little objective data exist for complications associated with CRRT. Santiago and colleagues are among the first to document four complications of acute kidney dysfunction in critically ill children: catheterization-related insertion complications, hypotension, hemorrhage, and electrolyte disturbances. They reported that hypotension at connection (41.3%) and electrolyte disturbance (50.6%) were the leading complications. Although this study is limited by small sample size and the outcome variables measured, it is an important first step in assessing outcomes of CRRT in children. A prospective multicenter randomized trial will be needed to fully delineate the complications and define the risk/benefit ratio of CRRT in children.