nach oben

Pediatric Nephrology

Erschienen in:

18.07.2017 | Review

Prolonged intermittent renal replacement therapy in children

verfasst von: Rajiv Sinha, Sidharth Kumar Sethi, Timothy Bunchman, Valentine Lobo, Rupesh Raina

Erschienen in: Pediatric Nephrology | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities. Acute PD has its drawbacks, and intermittent HD (IHD) done slowly over a prolonged period has been explored as an alternative. Various modes of slow sustained IHD have been described in the literature with the recently introduced term prolonged intermittent RRT (PIRRT) serving as an umbrella terminology for all of these modes. PIRRT has been widely accepted in adults with studies showing it to be as effective as CVVH/D but with an added advantage of being more cost-effective. Pediatric data, though scanty, has been promising. In this current review, we elaborate on the practical aspects of undertaking PIRRT in children as well as summarize its current status.

Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, Liu KD, Mehta RL, Pannu N, Van Biesen W, Vanholder R (2013) Acute kidney injury: an increasing global concern. Lancet 382:170–179CrossRefPubMed

Kidney Disease Improving Global Outcomes (2012) KDIGO Clinical Practice Guideline for Acute Kidney Injury. Available from http://kdigo.org/guidelines/acute-kidney-injury-2/ Accessed 13.04.17

Sutherland SM, Zappitelli M, Alexander SR, Chua AN, Brophy PD, Bunchman TE, Hackbarth R, Somers MJ, Baum M, Symons JM, Flores FX, Benfield M, Askenazi D, Chand D, Fortenberry JD, Mahan JD, McBryde K, Blowey D, Goldstein SL (2010) Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. Am J Kidney Dis 55:316–325CrossRefPubMed

Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstädt H, Boanta A, Gerß J, Meersch M (2016) Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury. JAMA 315:2190–2199CrossRefPubMed

Bagshaw SM, George C, Bellomo R, Database Management Committee ANZICS (2008) Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 12:R47CrossRefPubMedPubMedCentral

Honore PM, Jacobs R, Hendrickx I, Bagshaw SM, Joannes-Boyau O, Boer W, De Waele E, Van Gorp V, Spapen HD (2015) Prevention and treatment of sepsis-induced acute kidney injury: an update. Ann Intensive Care 5:51CrossRefPubMedPubMedCentral

Wu VC, Huang TM, Shiao CC, Lai CF, Tsai PR, Wang WJ, Huang HY, Wang KC, Ko WJ, Wu KD, NSARF Group (2013) The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study. J Neurosurg 119:1288–1295CrossRefPubMed

Ponce D, Buffarah MB, Goes C, Balbi A (2015) Peritoneal dialysis in acute kidney injury: trends in the outcome across time periods. PLoS One 10:e0126436CrossRefPubMedPubMedCentral

Phu NH, Hien TT, Mai NT, Chau TT, Chuong LV, Loc PP, Winearls C, Farrar J, White N, Day N (2002) Hemofiltration and peritoneal dialysis in infection-associated acute renal failure in Vietnam. N Engl J Med 347:895–902CrossRefPubMed

10.

Ponce D, Berbel MN, Abrão JM, Goes CR, Balbi AL (2013) A randomized clinical trial of high volume peritoneal dialysis versus extended daily hemodialysis for acute kidney injury patients. Int Urol Nephrol 45:869–878CrossRefPubMed

11.

Ponce D, Gobo-Oliveira M, Balbi AL (2017) Peritoneal dialysis treatment modality option in acute kidney injury. Blood Purif 43:173–178CrossRefPubMed

12.

Almeida CP, Ponce D, de Marchi AC, Balbi AL (2014) Effect of peritoneal dialysis on respiratory mechanics in acute kidney injury patients. Perit Dial Int 34:544–549CrossRefPubMedPubMedCentral

13.

Bonilla-Félix M (2009) Peritoneal dialysis in the pediatric intensive care unit setting. Perit Dial Int 29(Suppl 2):S183–S185PubMed

14.

Fortenberry JD, Paden ML, Goldstein SL (2013) Acute kidney injury in children: an update on diagnosis and treatment. Pediatr Clin N Am 60:669–688CrossRef

15.

Basu RK, Wheeler DS, Goldstein S, Doughty L (2011) Acute renal replacement therapy in pediatrics. Int J Nephrol 2011:785392CrossRefPubMedPubMedCentral

16.

Sutherland SM, Alexander SR (2012) Continuous renal replacement therapy in children. Pediatr Nephrol 27:2007–2016CrossRefPubMed

17.

Legrand M, Darmon M, Joannidis M, Payen D (2013) Management of renal replacement therapy in ICU patients: an international survey. Intensive Care Med 39:101–108CrossRefPubMed

18.

Wu VC, Wang CH, Wang WJ, Lin YF, Hu FC, Chen YW, Chen YS, Wu MS, Lin YH, Kuo CC, Huang TM, Chen YM, Tsai PR, Ko WJ, Wu KD, NSARF Study Group (2010) Sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for postsurgical acute renal failure. Am J Surg 199:466–476CrossRefPubMed

19.

Cheng J, Hu S, Lu H, Lei Q, Liu J, Yuan F, Chen R (2013) Comparison of the therapeutic effectiveness of sustained low-efficiency dialysis (SLED) with continuous blood purification (CBP) in critically ill patients. Cell Biochem Biophys 67:923–927CrossRefPubMed

20.

Caires RA, Abdulkader RC, Costa E Silva VT, Ferreira GS, Burdmann EA, Yu L, Macedo E (2016) Sustained low-efficiency extended dialysis (SLED) with single-pass batch system in critically-ill patients with acute kidney injury (AKI). J Nephrol 29:401–409CrossRefPubMed

21.

Zhang L, Yang J, Eastwood GM, Zhu G, Tanaka A, Bellomo R (2015) Extended daily dialysis versus continuous renal replacement therapy for acute kidney injury: a meta-analysis. Am J Kidney Dis 66:322–330CrossRefPubMed

22.

Abe M, Okada K, Suzuki M, Nagura C, Ishihara Y, Fujii Y, Ikeda K, Kaizu K, Matsumoto K (2010) Comparison of sustained hemodiafiltration with continuous venovenous hemodiafiltration for the treatment of critically ill patients with acute kidney injury. Artif Organs 34:331–338CrossRefPubMed

23.

Marshall MR, Golper TA, Shaver MJ, Alam MG, Chatoth DK (2001) Sustained low-efficiency dialysis for critically ill patients requiring renal replacement therapy. Kidney Int 60:777–785CrossRefPubMed

24.

Naka T, Baldwin I, Bellomo R, Fealy N, Wan L (2004) Prolonged daily intermittent renal replacement therapy in ICU patients by ICU nurses and ICU physicians. Int J Artif Organs 27:380–387CrossRefPubMed

25.

Fieghen HE, Friedrich JO, Burns KE, Nisenbaum R, Adhikari NK, Hladunewich MA, Lapinsky SE, Richardson RM, Wald R, University of Toronto Acute Kidney Injury Research Group (2010) The hemodynamic tolerability and feasibility of sustained low efficiency dialysis in the management of critically ill patients with acute kidney injury. BMC Nephrol 11:32CrossRefPubMedPubMedCentral

26.

Kron J, Kron S, Wenkel R, Schuhmacher HU, Thieme U, Leimbach T, Kern H, Neumayer HH, Slowinski T (2012) Extended daily on-line high-volume haemodiafiltration in septic multiple organ failure: a well-tolerated and feasible procedure. Nephrol Dial Transplant 27:146CrossRefPubMed

27.

Lee CY, Yeh HC, Lin CY (2016) Treatment of critically ill children with kidney injury by sustained low-efficiency daily diafiltration. Pediatr Nephrol 27:2301–2309CrossRef

28.

Edrees F, Li T, Vijayan A (2016) Prolonged intermittent renal replacement therapy. Adv Chronic Kidney Dis 23:195–202CrossRefPubMed

29.

Kielstein JT, Schiffer M, Hafer C (2010) Back to the future: extended dialysis for treatment of acute kidney injury in the intensive care unit. J Nephrol 23:494–501PubMed

30.

Himmelfarb J, Ikizler TA (2000) Quantitating urea removal in patients with acute renal failure: lost art or forgotten science? Semin Dial 13:147–149CrossRefPubMed

31.

Kudoh Y, Iimura O (1988) Slow continuous hemodialysis—new therapy for acute renal failure in critically ill patients–part 1. Theoretical consideration and new technique Jpn Circ J 52:1171–1182CrossRefPubMed

32.

Kudoh Y, Shiiki M, Sasa Y, Hotta D, Nozawa A, Iimura O (1988) Slow continuous hemodialysis—new therapy for acute renal failure in critically ill patients—part 2. Animal experiments and clinical implication. Jpn Circ J 52:1183–1190CrossRefPubMed

33.

Schlaeper C, Amerling R, Manns M, Levin NW (1999) High clearance continuous renal replacement therapy with a modified dialysis machine. Kidney Int Suppl 72:S20–S23CrossRef

34.

Berbece AN, Richardson RM (2006) Sustained low-efficiency dialysis in the ICU: cost, anticoagulation, and solute removal. Kidney Int 70:963–968

35.

Clark JA, Schulman G, Golper TA (2008) Safety and efficacy of regional citrate anticoagulation during 8-hour sustained lowefficiency dialysis. Clin J Am Soc Nephrol 3:736–742

36.

Fiaccadori E, Regolisti G, Cademartiri C, Cabassi A, Picetti E, Barbagallo M, Gherli T, Castellano G, Morabito S, Maggiore U (2013) Efficacy and safety of a citrate-based protocol for sustained low-efficiency dialysis in AKI using standard dialysis equipment. Clin J Am Soc Nephrol 8:1670–1678

37.

Schwenger V, Weigand MA, Hoffmann O, Dikow R, Kihm LP, Seckinger J, Miftari N, Schaier M, Hofer S, Haar C, Nawroth PP, Zeier M, Martin E, Morath C (2012) Sustained low efficiency dialysis using a single-pass batch system in acute kidney injury—a randomized interventional trial: the REnal replacement therapy study in intensive care unit PatiEnts. Crit Care 16:R140

38.

Kielstein JT, Kretschmer U, Ernst T, Hafer C, Bahr MJ, Haller H, Fliser D (2004) Efficacy and cardiovascular tolerability of extended dialysis in critically ill patients: a randomized controlled study. Am J Kidney Dis 43:342–349

39.

Kumar VA, Craig M, Depner TA, Yeun JY (2000) Extended daily dialysis: a new approach to renal replacement for acute renal failure in the intensive care unit. Am J Kidney Dis 36:294–300

40.

Lonnemann G, Floege J, Kliem V, Brunkhorst R, Koch KM (2000) Extended daily veno-venous high-flux haemodialysis in patients with acute renal failure and multiple organ dysfunction syndrome using a single path batch dialysis system. Nephrol Dial Transplant 15:1189–1193

41.

Albino BB, Balbi AL, Abrao JM, Ponce D (2015) Dialysis complications in acute kidney injury patients treated with prolonged intermittent renal replacement therapy sessions lasting 10 versus 6 hours: results of a randomized clinical trial. Artif Organs 39:423–431

42.

Marshall MR, Ma T, Galler D, Rankin AP, Williams AB (2004) Sustained low-efficiency daily diafiltration (SLEDD-f) for critically ill patients requiring renal replacement therapy: towards an adequate therapy. Nephrol Dial Transplant 19:877–884

43.

Bunchman TE (2008) Treatment of acute kidney injury in children: from conservative management to renal replacement therapy. Nat Clin Pract Nephrol 4:510–514

44.

Basu RK, Devarajan P, Wong H, Wheeler DS (2011) An update and review of acute kidney injury in pediatrics. Pediatr Crit Care Med 12:339–347

45.

Fliser D, Kielstein JT (2006) Technology insight: treatment of renal failure in the intensive care unit with extended dialysis. Nat Clin Pract Nephrol 2:32–39

46.

Overberger P, Pesacreta M, Palevsky PM, VA/NIH Acute Renal Failure Trial Network (2007) Management of renal replacement therapy in acute kidney injury: a survey of practitioner prescribing practices. Clin J Am Soc Nephrol 2:623–630

47.

Basso F, Ricci Z, Cruz D, Ronco C (2010) International survey on the management of acute kidney injury in critically ill patients: year 2007. Blood Purif 30:214–220

48.

Annigeri RA, Nandeesh V, Karuniya R, Rajalakshmi S, Venkataraman R, Ramakrishnan N (2016) Impact of dialysis practice patterns on outcomes in acute kidney injury in intensive care unit. Indian J Crit Care Med 20:14–20

49.

Ledebo I (2002) On-line preparation of solutions for dialysis: practical aspects versus safety and regulations. J Am Soc Nephrol 13(Suppl 1):S78–S83

50.

Vaslaki L, Karátson A, Vörös P, Major L, Pethö F, Ladányi E, Weber C, Mitteregger R, Falkenhagen D (2000) Can sterile and pyrogen-free on-line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on-line haemodiafiltration. Nephrol Dial Transplant 15(Suppl 1):74–78

51.

Lima EQ, Silva RG, Donadi EL, Fernandes AB, Zanon JR, Pinto KR, Burdmann EA (2012) Prevention of intradialytic hypotension in patients with acute kidney injury submitted to sustained low-efficiency dialysis. Ren Fail 34:1238–1243

52.

Tolwani AJ, Wheeler TS, Wille KM (2007) Sustained low-efficiency dialysis. Contrib Nephrol 156:320–324

53.

Morabito S, Pistolesi V, Tritapepe L, Fiaccadori E (2014) Regional citrate anticoagulation for RRTs in critically ill patients with AKI. Clin J Am Soc Nephrol 9:2173–2188

54.

Lahmer T, Messer M, Rasch S, Beitz A, Schnappauf C, Schmid RM, Huber W (2015) Sustained low-efficiency dialysis with regional citrate anticoagulation in medical intensive care unit patients with liver failure: a prospective study. J Crit Care 30:1096–1100

55.

Kitchlu A, Adhikari N, Burns KE, Friedrich JO, Garg AX, Klein D, Richardson RM, Wald R (2015) Outcomes of sustained low efficiency dialysis versus continuous renal replacement therapy in critically ill adults with acute kidney injury: a cohort study. BMC Nephrol 16:127

56.

Gashti CN, Salcedo S, Robinson V, Rodby RA (2008) Accelerated venovenous hemofiltration: early technical and clinical experience. Am J Kidney Dis 51:804–810

57.

Madison J, Ilumin M, Chin A (2005) Citrate-containing dialysate is well tolerated during slow extended daily dialysis in the ICU. J Am Soc Nephrol 16:314A

58.

Schetz M (1999) Non-renal indications for continuous renal replacement therapy. Kidney Int 56(Suppl 72):S88–S94CrossRef

59.

Tonelli M, Manns B, Feller-Kopman D (2002) Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery. Am J Kidney Dis 40:875–885CrossRefPubMed

60.

Kellum JA, Angus DC, Johnson JP, Leblanc M, Griffin M, Ramakrishnan N, Linde-Zwirble WT (2002) Continuous versus intermittent renal replacement therapy: a meta-analysis. Intensive Care Med 28:29–37CrossRefPubMed

61.

Pannu N, Klarenbach S, Wiebe N, Manns B, Tonelli M, Network AKD (2008) Renal replacement therapy in patients with acute renal failure: a systematic review. JAMA 299:793–805CrossRefPubMed

62.

Liao Z, Zhang W, Hardy PA, Poh CK, Huang Z, Kraus MA, Clark WR, Gao D (2003) Kinetic comparison of different acute dialysis therapies. Artif Organs 27:802–807CrossRefPubMed

63.

Kumar VA, Yeun JY, Depner TA, Don BR (2004) Extended daily dialysis vs. continuous hemodialysis for ICU patients with acute renal failure: a two-year single center report. Int J Artif Organs 27:371–379CrossRefPubMed

64.

Walters S, Porter C, Brophy PD (2009) Dialysis and pediatric acute kidney injury: choice of renal support modality. Pediatr Nephrol 24:37–48CrossRefPubMed

65.

Ghahramani N, Shadrou S, Hollenbeak C (2008) A systematic review of continuous renal replacement therapy and intermittent haemodialysis in management of patients with acute renal failure. Nephrology (Carlton) 13:570–578CrossRef

66.

Rabindranath K, Adams J, Macleod AM, Muirhead N (2007) Intermittent versus continuous renal replacement therapy for acute renal failure in adults. Cochrane Database Syst Rev 3:CD003773

67.

Schneider AG, Bellomo R, Bagshaw SM, Glassford NJ, Lo S, Jun M, Cass A, Gallagher M (2013) Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis. Intensive Care Med 39:987–997CrossRefPubMed

68.

Ponce D, Abrão JM, Albino BB, Balbi AL (2013) Extended daily dialysis in acute kidney injury patients: metabolic and fluid control and risk factors for death. PLoS One 8:e81697CrossRefPubMedPubMedCentral

69.

Gabriel DP, Nascimento GV, Caramori JT, Martim LC, Barretti P, Balbi AL (2007) High volume peritoneal dialysis for acute renal failure. Perit Dial Int 27:277–282PubMed

70.

Gabriel DP, Caramori JT, Martim LC, Barretti P, Balbi AL (2008) High volume peritoneal dialysis vs daily hemodialysis: a randomized, controlled trial in patients with acute kidney injury. Kidney Int Suppl 73:S87–S93CrossRef

71.

Ponce D, Berbel MN, Regina de Goes C, Almeida CT, Balbi AL (2012) High-volume peritoneal dialysis in acute kidney injury: indications and limitations. Clin J Am Soc Nephrol 7:887–894CrossRefPubMed

72.

Faulhaber-Walter R, Hafer C, Jahr N, Vahlbruch J, Hoy L, Haller H, Fliser D, Kielstein JT (2009) The Hannover dialysis outcome study: comparison of standard versus intensified extended dialysis for treatment of patients with acute kidney injury in the intensive care unit. Nephrol Dial Transplant 24:2179–2186CrossRefPubMed

73.

Mei JP, Ali-Moghaddam A, Mueller BA (2016) Survey of pharmacists’ antibiotic dosing recommendations for sustained low-efficiency dialysis. Int J Clin Pharm 38:127–134CrossRefPubMed

74.

Kielstein JT, Czock D, Schopke T, Hafer C, Bode-Böger SM, Kuse E, Keller F, Fliser D (2006) Pharmacokinetics and total elimination of meropenem and vancomycin in intensive care unit patients undergoing extended daily dialysis. Crit Care Med 34:51–56CrossRefPubMed

75.

Kielstein JT, Eugbers C, Bode-Boeger SM, Martens-Lobenhoffer J, Haller H, Joukhadar C, Traunmüller F, Knitsch W, Hafer C, Burkhardt O (2010) Dosing of daptomycin in intensive care unit patients with acute kidney injury undergoing extended dialysis—a pharmacokinetic study. Nephrol Dial Transplant 25:1537–1541CrossRefPubMed

76.

Lorenzen JM, Broll M, Kaever V, Burhenne H, Hafer C, Clajus C, Knitsch W, Burkhardt O, Kielstein JT (2012) Pharmacokinetics of ampicillin/ sulbactam in critically ill patients with acute kidney injury undergoing extended dialysis. Clin J Am Soc Nephrol 7:385–390CrossRefPubMedPubMedCentral

77.

Fiaccadori E, Maggiore U, Rotelli C, Giacosa R, Parenti E, Picetti E, Sagripanti S, Manini P, Andreoli R, Cabassi A (2004) Removal of linezolid by conventional intermittent hemodialysis, sustained low-efficiency dialysis, or continuous venovenous hemofiltration in patients with acute renal failure. Crit Care Med 32:2437–2442CrossRefPubMed

78.

Golestaneh L, Gofran A, Mokrzycki MH, Chen JL (2009) Removal of vancomycin in sustained low-efficiency dialysis (SLED): a need for better surveillance and dosing. Clin Nephrol 72:286–291CrossRefPubMed

79.

Roberts JA, Field J, Visser A, Whitbread R, Tallot M, Lipman J, Kirkpatrick CM (2010) Using population pharmacokinetics to determine gentamicin dosing during extended daily diafiltration in critically ill patients with acute kidney injury. Antimicrob Agents Chemother 54:3635–3640CrossRefPubMedPubMedCentral

80.

Manley HJ, Bailie GR, McClaran ML, Bender WL (2003) Gentamicin pharmacokinetics during slow daily home hemodialysis. Kidney Int 63:1072–1078CrossRefPubMed

81.

Bogard KN, Peterson NT, Plumb TJ, Erwin MW, Fuller PD, Olsen KM (2011) Antibiotic dosing during sustained low-efficiency dialysis: special considerations in adult critically ill patients. Crit Care Med 39:560–570CrossRefPubMed

82.

Burkhardt O, Hafer C, Langhoff A, Kaever V, Kumar V, Welte T, Haller H, Fliser D, Kielstein JT (2009) Pharmacokinetics of ertapenem in critically ill patients with acute renal failure undergoing extended daily dialysis. Nephrol Dial Transplant 24:267–271CrossRefPubMed

83.

Ahern JW, Lai C, Rebuck JA, Possidente CJ, Weidner M (2004) Experience with vancomycin in patients receiving slow low-efficiency dialysis. Hosp Pharm 39:138–143CrossRef

84.

Czock D, Hüsig-Linde C, Langhoff A, Schöpke T, Hafer C, de Groot K, Swoboda S, Kuse E, Haller H, Fliser D, Keller F, Kielstein JT (2006) Pharmacokinetics of moxifloxacin and levofloxacin in intensive care unit patients who have acute renal failure and undergo extended daily dialysis. Clin J Am Soc Nephrol 1:1263–1268CrossRefPubMed

85.

Clajus C, Kühn-Velten WN, Schmidt JJ, Lorenzen JM, Pietsch D, Beutel G, Kielstein JT (2013) Cotrimoxazole plasma levels, dialyzer clearance and total removal by extended dialysis in a patient with acute kidney injury: risk of under-dosing using current dosing recommendations. BMC Pharmacol Toxicol 14:19CrossRefPubMedPubMedCentral

86.

Mueller BA, Scoville BA (2012) Adding to the armamentarium: antibiotic dosing in extended dialysis. Clin J Am Soc Nephrol 7:373–375CrossRefPubMed

Titel: Prolonged intermittent renal replacement therapy in children
verfasst von: Rajiv Sinha
Sidharth Kumar Sethi
Timothy Bunchman
Valentine Lobo
Rupesh Raina
Publikationsdatum: 18.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 8/2018
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3732-2

Neu im Fachgebiet Pädiatrie

23.04.2024 | Typ-1-Diabetes | Nachrichten

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Prolonged intermittent renal replacement therapy in children

Abstract

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2018

Infections and the kidney: a tale from the tropics

Cystic renal mass in an infant with significant family history: Answers

Clinical value of ambulatory blood pressure in pediatric patients after renal transplantation

The role of von Willebrand factor in thrombotic microangiopathy

Using dynamic treatment regimes to understand erythropoietin-stimulating agent hyporesponsiveness

Renal, auricular, and ocular outcomes of Alport syndrome and their current management

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie