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CRRT – PICU AKI — RACP Paediatrics MCQ

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HardNephrologyCRRT – PICU AKIRACP Paediatrics

A child in PICU with multiorgan failure and severe AKI has hyperkalaemia (K 7.2), fluid overload (15% over dry weight), and metabolic acidosis refractory to medical management. What is the most appropriate acute dialysis modality?

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Correct answer: D — Continuous renal replacement therapy (CRRT)

CRRT (continuous renal replacement therapy, either CVVH or CVVHDF) is the preferred modality for critically ill children with AKI in the PICU setting. It provides gentle continuous fluid and solute removal with greater haemodynamic stability than intermittent HD. It is particularly suitable for haemodynamically unstable patients with multiorgan failure.

Reference: RCH Melbourne – 2023 – AKI CPG; RACP Paediatric Curriculum – Nephrology