Continuous Renal Replacement Therapy in Pediatric Patients with Hepatitis A Virus Associated ALF with Advanced Hepatic Encephalopathy – Effect on Survival

• Continuous renal replacement therapy (CRRT) is increasingly used for nonrenal indications in ICU.
• Early use of CRRT in acute liver failure (ALF) for hyperammonemia and HE III/IV is popular.
• However, only retrospective studies are available in ALF.
• Radionuclide computed tomography (RCT) on CRRT in nonrenal settings (septic shock) has shown no survival benefit.
• CRRT does not increase survival in ALF HE III/IV.
• CRRT does not affect bilirubin and inotrope requirement; decreases ammonia.
• KCH and failure to reduce ammonia are predictors of mortality.
• RCT is required to assess the effect of CRRT on survival.