CKRT with Oxiris® in Pediatric Critical Illness: Experience from a Tertiary Care Center in India

 

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CKRT with Oxiris® in Pediatric Critical Illness: Experience from a Tertiary Care Center in India

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DR SHUBHAM
MITTAL
DR SHUBHAM MITTAL shubhammittal962@gmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India *
DR KANAV ANAND anand@yahoo.co.uk SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DR ANSHU ARORA aroraanshu266@gmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DR VIVEK KUMAR 955vivekkumar@gmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DR DAMINI KHARKWAL daminikharkwal15@gmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DR SHIVANGI PURI shivangipuri1067@gmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
DR PK PRUTHI pkpruthi@hotmail.com SIR GANGA RAM HOSPITAL PEDIATRIC NEPHROLOGY DELHI India -
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To evaluate the impact of Continuous Kidney Replacement Therapy (CKRT) using the Oxiris® filter on biochemical and clinical outcomes in critically ill pediatric patients with weight >30 kgs presenting with hyper-inflammatory states, including sepsis-associated cytokine storm, acute liver failure (ALF), and acute kidney injury (AKI) with pulmonary edema.

A retrospective observational study was conducted on 20 children treated with CKRT with Oxiris® filter at Sir Ganga Ram Hospital, New Delhi from January 2025 to September 2025. Filter use followed predefined clinical indications. Laboratory parameters—Ferritin, C-reactive protein (CRP), Interleukin-6 (IL-6), Procalcitonin (PCT), SGOT/SGPT, serum creatinine were recorded at baseline (≤6 hours before CRRT), point A (6–12 hours after initiation), and point B (24–36 hours after initiation).

The median age was 14.5 years (10-18 years) with median weight was 38kg (20-60 kg). Sepsis-associated cytokine storm was seen in 50% (n = 10), ALF in 40% (n = 8), and AKI with pulmonary edema in 10% (n = 2). IL-6 showed a significant early reduction at Point A(median = 53.25%, IQR = 29.2; p < 0.05), with further decline at Point B (median = 87.48%, IQR = 25.43). PCT decreased by 70.7%(IQR = 48.02), CRP by 48%, and ferritin by 20% at Point A, improving further by Point B (PCT = 94.7%, CRP = 81.98%, ferritin = 75.6%). Amongst transaminases SGOT showed mean decline of 31% and SGPT by 27%. In patients with AKI with pulmonary edema, creatinine reduced by 95% at Point B. Early biomarker suppression correlated with hemodynamic stabilization in survivors with mortality rate of mere 10%.

Early initation of CKRT with oxiris filter had augmented our outcomes as it may rapidly attenuate inflammatory mediators and promote early stabilization in critically ill pediatric patients. The AN69 hydrogel membrane enables combined hemofiltration, cytokine adsorption and endotoxin removal, offering a promising adjunct for managing sepsis,ALF and AKI. Further prospective studies are needed to confirm these findings and define its role in pediatric critical care.

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