Blood filters in children with COVID-19 and acute kidney injury: A review

Ther Apher Dial. 2022 Jun;26(3):566-582. doi: 10.1111/1744-9987.13793. Epub 2022 Jan 29.

Abstract

COVID-19 has challenged the global healthcare system through rapid proliferation and lack of existing treatment resulting in over 180 million cases and 3.8 million deaths since December 2019. Although pediatric patients only comprise 1%-2% of diagnosed cases, their incidence of acute kidney injury ranges from 8.2% to 18.2% compared to 49% in adults. Severe infection, initiated by dysregulated host response, can lead to multiorgan failure. In this review, we focus on the use of various blood filters approved for use in pediatric kidney replacement therapy to mitigate adverse effects of severe illness. Therapeutic effects of these blood filters range from cytokine removal (CytoSorb, HA330, HCO/MCO), endotoxin removal (Toraymyxin, CPFA), both cytokine and endotoxin removal (oXiris), and nonspecific removal of proteins (PMMA) that have already been established and can be used to mitigate the various effects of the cytokine storm syndrome in COVID-19.

Keywords: COVID-19; CVVHDF; CytoSorb; blood filters; oXiris.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / therapy
  • Adult
  • COVID-19* / therapy
  • Child
  • Cytokines / metabolism
  • Endotoxins
  • Female
  • Humans
  • Male
  • Renal Replacement Therapy / methods

Substances

  • Cytokines
  • Endotoxins