The implementation of neonatal peritoneal dialysis in a clinical setting.

Abstract

OBJECTIVE:

To investigate etiology, outcome and complications related to neonatal peritoneal dialysis (PD).

METHODS:

Neonates treated with PD in our neonatal intensive care unit during 2007-2010 were analyzed retrospectively.

RESULTS:

Among 4036 hospitalized neonates; 20 neonates (0.5%) who underwent 21 cycles of PD [7 preterm, 13 term; 13 female, 7 male] were included. The mean birth weight was 2930.2 ± 720.6 g (1120-4570), mean gestational age was 37.5 ± 3.5 weeks (27-41). The etiologic disorders included inborn errors of metabolism (propionic acidemia, methylmalonic acidemia, citrullinemia, glutaric aciduria type 2, maple syrup urine disease, 10), or acute renal failure secondary to perinatal asphyxia (4), sepsis (2), prematurity (2), hypoplastic left heart syndrome (1), kernicterus (1). The complications included peritonitis (2), early leakage (4), hemorrhage (1), catheter removal (3) and occlusion (2). The mortality rate was 50%. The gestational ages and birth weights of surviving neonates were higher (p < 0.05). Among surviving neonates, chronic renal failure (1), severe (4) and moderate neuromotor impairment (2) developed within 4-43 months.

CONCLUSION:

PD, although invasive, is an effective therapy in neonates. The complexity and invasiveness of the procedure is probably responsible for high rate of complications and mortality. If appropriate catheter selection and technique in the placement should be done, PD might improve outcome.

• Authors: Sevim Unal, Leyla Bilgin, Mehmet Gunduz, Nermin Uncu, Mujdem Nur Azili, Tugrul Tiryaki
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 25 Issue 10 Pg. 2111-4 (Oct 2012) ISSN: 1476-4954 [Electronic] England
• PMID: 22420616 (Publication Type: Evaluation Study, Journal Article)

Topics

• Acute Kidney Injury (etiology, mortality, therapy)
• Female
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (mortality, therapy)
• Intensive Care, Neonatal (methods)
• Male
• Metabolism, Inborn Errors (mortality, therapy)
• Peritoneal Dialysis (adverse effects, methods, mortality)
• Retrospective Studies
• Treatment Outcome