Document Type : Original Article
Neonatologist, Associate Professor, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mashhad University of Medical Sciences, Mashhad, Iran
Department of Internal Medicine, Szeged Medical University, Szeged, Hungary
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.