Haemofiltration therapy – a sturdy pair of shoes!

The spectrum of indications and availability of continuous renal replacement therapy (CRRT) have increased massively over the last three decades. The availability of commercially produced equipment has reduced many of the associated risks. The mortality associated with paediatric CRRT remains significant and reflects the severity of the underlying aetiologies.Whilst little evidence exists to identify the best modality of CRRT, haemofiltration (HF) has obvious advantages in unstable patients and is ideal for many critically ill, haemodynamically labile children. Owing to its superior clearance of middle molecules, it may still prove itself valuable in future prospective studies of sepsis and immunomodulation.The ongoing prospective paediatric CRRT registry may yet shed further light on many of the issues outlined in this review.