Modified aquapheresis for the smallest patients in intensive care
To date, four patients have benefited from modified aquapheresis at Children’s National in both the PICU and the CICU.
The Division of Nephrology at Children’s National Hospital now offers modified aquapheresis for the smallest patients with acute kidney injury or chronic kidney disease in intensive care units. Aadil Kakajiwala, M.D., MSCI, director of Pediatric Acute Kidney Support Therapies, has been the leader in establishing modified aquapheresis at Children’s National. He joined the faculty at Children’s National in 2021 after completing his pediatric nephrology fellowship at the Children’s Hospital of Philadelphia and pediatric critical care medicine fellowship at Children’s National.
To date, four patients have benefited from modified aquapheresis at Children’s National in both the PICU and the CICU. Dialysis equipment designed for adults has filter set volumes as high as 165ml. Since implementing modified aquapheresis, the new equipment’s filter set volume is just 35ml, making it a great option for dialyzing small patients as low as 1.8kg. This limits blood exposure to the patient and overcomes the limitation of obtaining larger vascular access by using a PICC line.
Dr. Kakajiwala looks to continue training nephrologists, intensive care unit providers and staff across the hospital on modified aquapheresis. “This new offering allows us to offer dialysis to our smallest patients. By utilizing modified aquapheresis, we ensure simultaneous removal of waste products along with fluid removal during the therapy,” says Dr. Kakajiwala. He hopes to work on standardizing all forms of renal replacement therapy offered at Children’s National across all care providers.
