The Acute Temporary Peritoneal Dialysis in Neonates: A Five-Year Experience

Document Type : Original Article

Authors

1 Neonatologist, Associate Professor, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Internal Medicine, Szeged Medical University, Szeged, Hungary

Abstract

Background: The aim of this prospective study was to evaluate the characteristics of patients, treated by acute peritoneal dialysis (PD). We also assessed the indications for PD, PD-associated complications and neonatal outcomes in our patients.
Methods: During five years, 30 term newborns underwent temporary cycling PD. The procedure was performed by applying the manual technique. A straight and relatively rigid peritocat catheter (Germany) was percutaneously inserted in neonates. Statistical analysis was performed, using Chi-square and student's t-test.
Results: All subjects were term newborns, including 16 females (52%) and 14 males (48%). In total, 16 cases (52%) were born via cesarean section. The average age and weight of neonates at catheter insertion were 15 days (range of 5-26 days) and 2800 g (range of 2300-4060 g), respectively. The mean PD duration was two days. There was no significant difference between gender, weight, mode of delivery and associated complications. In total, 74% of patients needed assisted ventilation. No case of death was reported due to catheter insertion; however, 12 patients (40%) died during PD. PD-related complications were reported in 70% of patients, and the most common complication was catheter outflow failure (14 cases, 46%). The underlying causes included inborn errors of metabolism (16 cases, 52%) and acute renal failure (14 cases, 48%). Urea cycle enzyme defect, along with hyperammonemia, was the most common etiologic disease (9 cases).
Conclusion: PD is an effective treatment for seriously ill newborns with life-threatening conditions such as acute renal failure or certain inborn errors of metabolism. However, mortality rate remains high due to the severity of underlying diseases and comorbidities.

Keywords

References

  1. Lee MM, Chua AN, Yorgin PD. Neonatal Peritoneal Dialysis. NeoReviews. 2005; 6:384-91.
  2. Matthews DE1, West KW, Rescorla FJ, Vane DW, Grosfeld JL, Wappner RS, et al. J Pediatr Surg. 1990; 25:110-5.
  3. Stojanovic V, Bukarica S,  Doronjski A, Marinkovic S. Peritoneal Dialysis in Neonates with Extremely Low Body Weight at Birth: New Modality of Using IV Cannula for Peritoneal Access. Iran J Pediatr. 2013; 23:718–20.
  4. Osichenko A, Maslarska R, Anadoliyski K. Application of petoneal dialysis in the neonatal period.A clinical case. J Clin Med. 2011; 4:72-5.
  5. Vogt BA, Dell KM. The kidney and urinary tract. In: Fanar off & Martin’s Neonatal– perinatal Medicine diseases of the fetus and infant. 9th ed. Philadelphia: Elsevirer Sauders; 2011.P.1689-9.
  6. Ash SR, Daugirdas JT. Peritoneal access devices. In:Hand book of dialysis. Daugirdas JT, Blake PG, Ing TS, editors. Philadelphia: Lippincott Williams & Wilkins; 2007.P.356-75.
  7. Haycock B. Management of acute and chronic renal failure in the newborn. Semin Neonatol. 2003; 8:325-34.
  8. Hakan N, Aydin M, Zenciroglu A, Aydog O, Erdogan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: A 7-year single-center experience at tertiary neonatal intensive care unit in Turkey . Am J Perinatol. 2014; 31:335-8.
  9. Huber R, Fuchshuber A, Huber P. Acute Peritoneal Dialysis in Preterm Newborns and Small Infants:Surgical Management . J Pediatr Surg. 1994; 29:400-2.

10. 10-Unal S, Bilgin L, Gunduz M, Uncu N, Azili MN, Tiryaki T. The implementation of neonatal peritoneal dialysis in a clinical setting.jMatern fetal Neonatal Med. 2012; 25(10):2111-4.

11. Alparslan C1, Yavascan O, Bal A, Kanik A, Kose E, Demir BK, et al. The performance of acute peritoneal dialysis treatment in neonatal period. Ren Fail. 2012; 34:1015-20.

12. Bilgin L, Unal S, Gunduz M, Uncu N, Tiryaki T. Utility of peritoneal dialysis in neonates affected by inborn errors of metabolism. J Paediatr Child Health. 2014; 50:531-5.

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