Background <p>In addition to the provision of kidney replacement therapy for children and adolescents with acute kidney injury (AKI), modern diagnostic and therapeutic options in the management of fluid overload, electrolyte abnormalities, inborn errors of metabolism, oncological emergencies hypertensive derailments, nutrition management and all types of renal and liver replacement procedures nowadays belong to the spectrum of pediatric nephrology in the intensive care unit.</p> Objective <p>The aim of this article is to highlight the use of continuous extracorporeal renal replacement procedures in cases of primary nonrenal underlying diseases.</p> Material and methods <p>Analysis of pediatric case reports and randomized controlled studies as well as inspection and discussion of guidelines and recommendations of specialist societies.</p> Results <p>Regardless the child’s age, continuous extracorporeal renal replacement therapy (CRRT) and hemodialysis are the gold standard in the treatment of AKI and acute volume overload on the pediatric intensive care unit. Recently, due to extended technical possibilities, non-renal mostly gastroenterological, oncological or metabolic indications are becoming the focus of pediatric nephrological care.</p> Conclusion <p>From early childhood on, most CRRT procedures can be safely carried out on the intensive care unit. This requires the cooperation of a multiprofessional team.</p>