Association of thrombocytopenia on secondary infection and mortality in pediatric intensive care unit patients receiving continuous renal replacement therapy

Aims: Continuous renal replacement therapy (CRRT) is a widely used treatment modality in pediatric patients. We aimed to evaluate the susceptibility of thrombocytopenia to secondary infection and mortality during intensive care unit admission and the initiation of CRRT in patients admitted to the pediatric intensive care unit. Methods: We conducted a retrospective study of patients in a tertiary pediatric intensive care unit who underwent CRRT between February 2021 and July 2024. The study included 34 patients who underwent CRRT. Results: The study population consisted of patients with a median age of 26 months and 58.8% were male. At pediatric intensive care units (PICU) admission, 10 (29.4%) patients had thrombocytopenia, whereas 15 (44.1%) had thrombocytopenia at CRRT initiation. Patients with thrombocytopenia at the start of CRRT had a greater risk of mortality. Mortality approached significance in patients with thrombocytopenia at PICU admission. The risk of infection was significantly increased in patients with thrombocytopenia at the start of CRRT according to univariate and multivariate regression analyses (p=0.01). Conclusion: The detection of thrombocytopenia at the beginning of CRRT is associated with a higher secondary infection rate and mortality during pediatric intensive care hospitalization. CRRT and thrombocytopenia negatively impact immune function, and further prospective studies are needed to assess their association with subsequent infection risk.