{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T21:13:40Z","timestamp":1778966020814,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Continuous kidney replacement therapy (CKRT) is the preferred modality in critically ill children with acute kidney injury. Upon improvement, intermittent hemodialysis is usually initiated as a step\u2010down therapy, which can be associated with several adverse events. Hybrid therapies such as Sustained low\u2010efficiency daily dialysis with pre\u2010filter replacement (SLED\u2010<jats:italic>f<\/jats:italic>) combines the slow sustained features of a continuous treatment, ensuring hemodynamic stability, with similar solute clearance along with the cost effectiveness of conventional intermittent hemodialysis. We examined the feasibility of using SLED\u2010<jats:italic>f<\/jats:italic> as a transition step\u2010down therapy after CKRT in critically ill pediatric patients with acute kidney injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was conducted in children admitted to our tertiary care pediatric intensive care units with multi\u2010organ dysfunction syndrome including acute kidney injury who received CKRT for management. Those patients receiving fewer than two inotropes to maintain perfusion and failed a diuretic challenge were switched to SLED\u2010<jats:italic>f<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven patients underwent 105 SLED\u2010<jats:italic>f<\/jats:italic> sessions (mean of 9.55 +\/\u2212 4.90 sessions per patient), as a part of step\u2010down therapy from continuous hemodiafiltration. All (100%) our patients had sepsis associated acute kidney injury with multiorgan dysfunction and required ventilation. During SLED\u2010<jats:italic>f<\/jats:italic>, urea reduction ratio was 64.1 +\/\u2212 5.3%, Kt\/V was 1.13 +\/\u2212 0.1, and beta\u20102 microglobulin reduction was 42.5 +\/\u22124%. Incidence of hypotension and requirement of escalation of inotropes during SLED\u2010<jats:italic>f<\/jats:italic> was 18.18%. Filter clotting occurred twice in one patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SLED\u2010<jats:italic>f<\/jats:italic> is a safe and effective modality for use as a transition therapy between CKRT and intermittent hemodialysis in children in the PICU.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.13088","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T08:15:10Z","timestamp":1682410510000},"page":"308-317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Switching from continuous veno\u2010venous hemodiafiltration to intermittent sustained low\u2010efficiency daily hemodiafiltration (SLED\u2010<i>f<\/i>) in pediatric acute kidney injury: A prospective cohort study"],"prefix":"10.1111","volume":"27","author":[{"given":"Sidharth Kumar","family":"Sethi","sequence":"first","affiliation":[{"name":"Pediatric Nephrology Kidney Institute, Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupesh","family":"Raina","sequence":"additional","affiliation":[{"name":"Akron Nephrology Associates Cleveland Clinic Akron General  Akron Ohio USA"},{"name":"Department of Pediatric Nephrology Akron Children's Hospital  Akron Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam Bihari","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Nephrology Kidney Institute, Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anvitha","family":"Soundararajan","sequence":"additional","affiliation":[{"name":"Akron Nephrology Associates Cleveland Clinic Akron General  Akron Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maninder","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Pediatric Critical Care Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veena","family":"Raghunathan","sequence":"additional","affiliation":[{"name":"Pediatric Critical Care Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meenal","family":"Kalra","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Kidney Institute, Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kritika","family":"Soni","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Kidney Institute, Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samit Kumar","family":"Mahato","sequence":"additional","affiliation":[{"name":"Maulana Azad Medical College  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananya","family":"Vadhera","sequence":"additional","affiliation":[{"name":"Maulana Azad Medical College  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Nephrology Kidney Institute, Medanta, The Medicity  Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Bunchman","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Children's Hospital of Richmond at VCU  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12605"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611391"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/1319-2442.344776"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cd12e1"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2016.03.003"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.10.048"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5828"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195536"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/785392"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.060002777.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.01.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-015-0224-y"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2009.00861.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.02.328"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12013-013-9583-y"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178233"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2254-1"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000003127"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-022-04214-z"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.04310422"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2009040366"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000506412"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00523.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1227-3"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0b013e3181611f552"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-022-05782-0"},{"issue":"1","key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/01.ccm.0000529385.17103.55","article-title":"1382: factors associated with successful discontinuation of CRRT IN children with acute kidney injury","volume":"46","author":"Modem V","year":"2018","journal-title":"Crit Care Med"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12821"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pcc.0000149131.72248.e6"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.67121.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.19.060"},{"key":"e_1_2_8_34_1","first-page":"1","article-title":"KDIGO clinical practice guide\u2010line for acute kidney injury","volume":"17","author":"Group KAW","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-005-1876-y"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398820952801"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs530"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2018.06.002"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq694"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfx110"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.07.015"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.56.s72.13.x"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5001700"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1594.2003.07282.x"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1272-7"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.10.021"},{"issue":"3","key":"e_1_2_8_47_1","first-page":"138","article-title":"The role of sustained low\u2010efficiency dialysis (SLED) in the intensive care unit","volume":"36","author":"Vicente R","year":"2022","journal-title":"Port J Nephrol Hypert"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg625"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802639"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902413"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/01823246-201223010-00002"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2015.03.032"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.13088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:50:21Z","timestamp":1692319821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.13088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,25]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/hdi.13088"],"URL":"https:\/\/doi.org\/10.1111\/hdi.13088","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"value":"1492-7535","type":"print"},{"value":"1542-4758","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,25]]},"assertion":[{"value":"2023-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}