Mortality of Critically Ill Children Requiring Continuous Renal Replacement Therapy: Effect of Fluid Overload, Underlying Disease, and Timing of Initiation

Objective: To identify risk factors associated with mortality in critically ill children requiring continuous renal replacement therapy. Design: Retrospective observational study based on a prospective registry. Setting: Tertiary and quaternary referral 30-bed PICU. Patients: Critically ill children undergoing continuous renal replacement therapy were included in the study. Interventions: Continuous renal replacement therapy. Measurements and Main Results: Overall mortality was 36% (n = 58) among the 161 patients treated with continuous renal replacement therapy during the study period and was significantly higher in patients on extracorporeal membrane oxygenation (47.5%, 28 of 59) than in patients not requiring extracorporeal membrane oxygenation (28.4%, 29 of 102; p = 0.022). According to the admission diagnosis, we found the highest mortality in patients with onco-hematologic disease (77.8%) and the lowest in patients with renal disease (5.6%). Based on multivariate logistic regression analysis, the presence of higher severity of illness score at admission (adjusted odds ratio, 1.49; 95% CI, 1.18–1.89; p

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