{"doi":"10.1007/s00467-024-06459-6","title":"Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p &lt; 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p &lt; 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Conclusion</jats:title>\n                <jats:p>Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Graphical abstract</jats:title>\n                \n              </jats:sec>","journal":"Pediatric Nephrology","year":2024,"id":617836,"datarank":0.37273599746820013,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.0,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1395196,"name":"Isabella Guzzo","orcid":"0000-0003-4960-3083","position":1,"is_corresponding":false},{"id":1395190,"name":"Andrea Cappoli","orcid":"0000-0003-0675-2708","position":2,"is_corresponding":false},{"id":1593482,"name":"Raffaella Labbadia","orcid":null,"position":3,"is_corresponding":false},{"id":1593483,"name":"Aysun Karabay Bayazit","orcid":null,"position":4,"is_corresponding":false},{"id":1593484,"name":"Dincer Yildizdas","orcid":null,"position":5,"is_corresponding":false},{"id":1178560,"name":"Claus Peter Schmitt","orcid":"0000-0003-4487-3332","position":6,"is_corresponding":false},{"id":1375828,"name":"Marcin Tkaczyk","orcid":"0000-0003-1753-7560","position":7,"is_corresponding":false},{"id":1593485,"name":"Mirjana Cvetkovic","orcid":null,"position":8,"is_corresponding":false},{"id":1593486,"name":"Mirjana Kostic","orcid":null,"position":9,"is_corresponding":false},{"id":1593487,"name":"Wesley Hayes","orcid":null,"position":10,"is_corresponding":false},{"id":19381,"name":"Rukshana Shroff","orcid":"0000-0001-8501-1072","position":11,"is_corresponding":false},{"id":1329265,"name":"Augustina Jankauskiene","orcid":null,"position":12,"is_corresponding":false},{"id":1593488,"name":"Ernestas Virsilas","orcid":null,"position":13,"is_corresponding":false},{"id":1593489,"name":"Germana Longo","orcid":null,"position":14,"is_corresponding":false},{"id":1593490,"name":"Enrico Vidal","orcid":null,"position":15,"is_corresponding":false},{"id":1593491,"name":"Sevgi Mir","orcid":null,"position":16,"is_corresponding":false},{"id":1593492,"name":"Ipek Kaplan Bulut","orcid":null,"position":17,"is_corresponding":false},{"id":1593493,"name":"Andrea Pasini","orcid":"0000-0002-9199-9088","position":18,"is_corresponding":false},{"id":1593494,"name":"Fabio Paglialonga","orcid":null,"position":19,"is_corresponding":false},{"id":1024616,"name":"Giovanni Montini","orcid":"0000-0002-7350-4475","position":20,"is_corresponding":false},{"id":560399,"name":"Ebru Yilmaz","orcid":"0000-0003-1033-1797","position":21,"is_corresponding":false},{"id":1593496,"name":"Liane Correia Costa","orcid":null,"position":22,"is_corresponding":false},{"id":1593498,"name":"Ana Teixeira","orcid":null,"position":23,"is_corresponding":false},{"id":12986,"name":"Franz Schaefer","orcid":"0000-0001-7564-9937","position":24,"is_corresponding":false},{"id":1593481,"name":"Anna Deja","orcid":"0000-0002-9901-4140","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p &lt; 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p &lt; 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Conclusion</jats:title>\n                <jats:p>Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Graphical abstract</jats:title>\n                \n              </jats:sec>","is_dataset_classified":null,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39023538","pmcid":"PMC11413113","openalex_id":"https://openalex.org/W4400760068","authors":[],"funders":[{"funder_name":"Baxter Healthcare Corporation","grant_id":"","title":null}],"total_grants":1,"fwci":2.702,"citation_percentile":0.91984431,"influential_citations":0,"citation_trend":[{"year":2025,"count":7},{"year":2026,"count":4}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://link.springer.com/content/pdf/10.1007/s00467-024-06459-6.pdf","host_type":"journal"},{"url":"https://link.springer.com/content/pdf/10.1007/s00467-024-06459-6.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1007/s00467-024-06459-6/fulltext.html","host_type":"publisher"},{"url":"https://doi.org/10.1007/s00467-024-06459-6","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39023538","host_type":"repository"},{"url":"https://hdl.handle.net/2434/1116121","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11413113","host_type":"repository"},{"url":"https://air.unimi.it/bitstream/2434/1116121/2/467_2024_Article_6459.pdf","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11413113/pdf/467_2024_Article_6459.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11413113","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11413113?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Acute Kidney Injury Research","Central Venous Catheters and Hemodialysis","Dialysis and Renal Disease Management","Child","Child, Preschool","Female","Humans","Infant","Male","Acute Kidney Injury","Anticoagulants","Continuous Renal Replacement Therapy","Heparin","Registries","Time Factors","Treatment Outcome","Prospective Studies"],"mesh_terms":["Continuous Renal Replacement Therapy","Adolescent","Anticoagulants","Child","Child, Preschool","Female","Heparin","Humans","Infant","Male","Prospective Studies","Registries","Time Factors","Treatment Outcome","Acute Kidney Injury"],"keywords":["Medicine","Nephrology","Renal replacement therapy","Internal medicine","Intensive care medicine","Acute Kidney Injury","Regional Citrate Anticoagulation","Continuous Kidney Replacement Therapy","Circuit Lifetime"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T02:45:43.085103Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}