Dialytic management of childhood acute renal failure: a survey of North American pediatric nephrologists.

A 35-question survey was mailed to 19 pediatric nephrologists regarding dialytic management of acute renal failure (ARF). Fifteen surveys were returned (79%). The purpose of the survey was to determine which renal replacement therapies (RRT) are most frequently used in the management of children with ARF in North America. Nephrologists were also questioned about clinical factors that influence the decisions to initiate RRT and choice of a particular modality. Survey results showed that hemofiltration was the initial choice for RRT among nephrologists (median value 40%, range 0%-100%) more often in their patients in the past 12 months than peritoneal dialysis (median value 30%, range 0%-85%) or hemodialysis (median value 20%, range 0%-50%). Factors considered most important in the decision to initiate dialysis include abnormalities in serum potassium, fluid balance, blood pressure and nutritional needs. Patient size and dialysis access were additional factors considered important in the choice of RRT modality.