Mehmet SATAR, Aysun KARABAY BAYAZIT, Hacer YAPICIOĞLU YILDIZDAŞ, Ferda ÖZLÜ, Gül ŞEKER, Hüseyin ŞİMŞEK

Peritoneal dialysis in neonates: six years of single center experience

Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acutekidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes ofPD between January 2011 and December 2016.Materials and methods: This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit(NICU). A retrospective chart review was performed for all patients in our institution.Results: The incidence of PD was 1.32% (56/4230 patients) during this period. Mean birth weight of the patients was 2267.77 ± 1060.63(540–5050) g. Thirty-four (60.7%) patients were premature. Fourteen patients (25%) were in the postoperative period of cardiac surgerydue to congenital cardiac defects, fourteen patients (25%) were diagnosed with metabolic diseases, one patient had hypoxic ischemicencephalopathy, and another patient had severe pulmonary hypertension.Conclusion: In the acute setting of a neonatal intensive care unit, PD performed in a neonate provides a technically simple method ofsteady fluid, solute removal, and correction of electrolyte abnormalities. A trocar catheter appears safe even in premature babies, andclosed three-way stopcock system seems to be reliable at the bedside in NICUs.

PDF

___

Lee MM, Chua AN, Yorgin PD. Neonatal peritoneal dialysis. Neoreviews 2005; 8: 384-391.
Popovich RP, Moncrief JW, Nolph KD. Continuous ambulatory peritoneal dialysis. Artif Organs 1978;2: 84-86.
National Kidney Foundation. Guidelines for Peritoneal Dialysis. New York, NY, USA: National Kidney Foundation, 2000. Available at: www.kidney.org/proffesionals/KDOQ/ guidelines_updates/doqiuppd_iii.html.
Sorof JM, Stromberg D, Brewer ED, Feltes TF, Fraser CD Jr. Early initiation of peritoneal dialysis after surgical repair of congenital heart disease. Pediatr Nephrol 1999; 13: 641-645.
Yu JE, Park MS, Pai KS. Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter. Pediatr Nephrol 2010; 25: 367-371.
Ustyol L, Peker E, Demir N, Agengin K, Tuncer O. The use of acute peritoneal dialysis in critically ill newborns. Med Sci Monit 2016; 22: 1421-1426.
Harshman LA, Muff-Luett M, Neuberger ML, Dagle JM, Shilyansky J, Nester CM, Brophy PD, Jetton JG. Peritoneal dialysis in an extremely low-birth-weight infant with acute kidney injury. Clin Kidney J 2014; 7: 582-585.
Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31.
Agras PI, Tarcan A, Baskin E, Cengiz N, Gürakan B, Saatci U. Acute renal failure in the neonatal period. Ren Fail 2004; 26: 305-309.
Tóth-Heyn P, Drukker A, Guignard JP. The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy. Pediatr Nephrol 2000; 14: 227-239.
Andreoli SP. Acute renal failure in the newborn. Semin Perinatol 2004; 28: 112-123.
Haycock GB. Management of acute and chronic renal failure in the newborn. Semin Neonatol 2003; 8: 325-334.
Macchini F, De Carli A, Testa S, Arnoldi R, Ghirardello S, Ardissino G, Mosca F, Torricelli M, Leva E. Feasibility of peritoneal dialysis in extremely low birth weight infants. J Neonat Surg 2012; 1: 52.
Coulthard MG, Vernon B. Managing acute renal failure in very low birth weight infants. Arch Dis Child 1995; 73: 187-192.
Pedersen KR, Povlsen JV, Christensen S, Pedersen J, Hjortholm K, Larsen SH, Hjortdal VE. Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children. Acta Anaesthesiol Scand 2007; 51: 1344-1349.
Boigner H, Brannath W, Hermon M, Stoll E, Burda G, Trittenwein G, Golej J. Predictors of mortality at initiation of peritoneal dialysis in children after cardiac surgery. Ann Thorac Surg 2004; 77: 61-65.
Chan KL, Ip P, Chiu CSW, Cheung YF. Peritoneal dialysis after surgery for congenital heart disease in infants and young children. Ann Thorac Surg 2003; 76: 1443-1449.
Hassinger AB, Wald EL, Goodman DM. Early postoperative fluid overload precedes acute kidney injury and is associated with higher morbidity in pediatric cardiac surgery patients. Pediatr Crit Care Med 2014; 15: 131-138.
Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatr 2005; 42: 928-934.
Kohli HS, Bhalla D, Sud K, Jha V, Gupta KL, Sakhuja V. Acute peritoneal dialysis in neonates: comparison of two types of peritoneal access. Pediatr Nephrol 1999; 13: 241-244.
Huber R, Fuchshuber A, Huber P. Acute peritoneal dialysis in preterm newborns and small infants: surgical management. J Pediatr Surg 1994; 29: 400-402.
Matthews DE, West KW, Rescorla FJ, Vane DW, Grosfeld JL, Wappner RS, Bergstein J, Andreoli S. Peritoneal dialysis in the first 60 days of life. J Pediatr Surg 1990; 25: 110-115.
Blowey DL, McFarland K, Alon U, McGraw-Houchens M, Hellerstein S, Warady BA. Peritoneal dialysis in the neonatal period: outcome data. J Perinatol 1993; 13: 59-66.
Maizlin II, Shroyer MC, Perger L, Chen MK, Beierle EA, Martin CA, Anderson SA, Mortellaro VE, Rogers DA, Russell RT. Outcome assessment of renal replacement therapy in neonates. J Surg Res 2016; 204: 34-38.
Golej J, Kitzmueller E, Hermon M, Boigner H, Burda G, Trittenwein G. Low-volume peritoneal dialysis in 116 neonatal and paediatric critical care patients. Eur J Pediatr 2002; 161: 385-389.
Alparslan C, Yavascan O, Bal A, Kanik A, Kose E, Demir BK, Aksu N. The performance of acute peritoneal dialysis treatment in neonatal period. Ren Fail 2012; 34: 1015-1020.
Unal S, Bilgin L, Gunduz M, Uncu N, Azili MN, Tiryaki T. The implementation of neonatal peritoneal dialysis in a clinical setting. J Matern-Fetal Neo M 2012; 25: 2111-2114.
Oyachi N, Obana K, Kimura S, Kubo M, Naito A, Nemoto A. Use of a flexible Blake® silicone drains for peritoneal dialysis in the neonatal intensive care unit. Pediatr Int 2011; 53: 417-418.
Yu JE, Park MS, Pai KS. Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter. Pediatr Nephrol 2010; 25: 367-371.