scholarly journals Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

scholarly journals Effect of Peritoneal Dialysis on Extremely Low Birth Weight Infants: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. There were two patients who had severe perinatal asphyxia (5-min Apgar score ≤3). The most important indication for starting PD was AKI due to sepsis. The average duration of PD was 9.4 (±7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (±4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%.Conclusions: The mortality rate of ELBW infants with AKI treated with PD is quite high because their organ system is not completely developed. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI.

scholarly journals Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Organ Systems

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD.Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours.Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %.Conclusions: In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

scholarly journals Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

2020 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Organ Systems

Abstract Background: Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods: In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 hours. Results: Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75 %). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7 %. Conclusions: In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation .

scholarly journals Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Asphyxia ◽  
Extremely Low Birth Weight ◽  
Organ Systems

Abstract Background Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 h. Results Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%. Conclusions In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.

scholarly journals Effects of Acute Peritoneal Dialysis in Extremely-Low-Birth-Weight Infants: A Retrospective Cohort Study

2019 ◽  
Author(s):  
Jihyun Noh ◽  
Chae Young Kim ◽  
Euiseok Jung ◽  
Joo Hoon Lee ◽  
Young-Seo Park ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Clinical Outcomes ◽  
Perinatal Asphyxia ◽  
Rescue Therapy ◽  
Insertion Site ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Tertiary Center

Abstract Background :Acute peritoneal dialysis (APD) is a first-line rescue therapy for neonatal acute kidney injury (AKI) refractory to conservative management, but its efficacy in preterm infants remains unclear. This study aimed to investigate the clinical outcomes of APD and APD efficiency in extremely-low-birth-weight (ELBW) infants. Methods : We reviewed the medical records of inborn ELBW infants who underwent APD in a tertiary center. We recorded perinatal characteristics, including the causes of AKI and clinical outcomes. Serial input and output data and laboratory parameters to assess ultrafiltration/dialysis efficiency were also obtained. Results : A total of 12 ELBW infants were included in the study. Mean gestational age and birth weight were 27.2 weeks and 706.5 g, respectively. Leading cause of AKI was sepsis (50%) followed by perinatal asphyxia. Mean age at the start of PD was 16.3 days. Mean ultrafiltration (UF) rate was 2.73 mL/kg/h. After a mean duration of 9.4 days, the mean reduction in serum BUN and Cr levels was 42.5% and 20.1%, respectively. Mean sodium level increased from 135.8 to 144.7 mg/mL, and mean potassium level decreased from 6.8 to 5.0 mg/mL. The most common complication was mechanical dysfunction of the catheter, including dialysate leakage via the insertion site (75%). Only two patients were successfully weaned off APD. The overall mortality rate was 92%. Conclusions : In ELBW infants with AKI, APD was an effective rescue therapy in terms of its ultrafiltration and dialysis efficiency, but not with respect to neonatal mortality. Indications for APD in ELBW infants should be individualized depending on the etiology of AKI.

Peritoneal dialysis in extremely and very low-birth-weight infants

2020 ◽  
Vol 40 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Kathrin Burgmaier ◽  
Agnes Hackl ◽  
Rasmus Ehren ◽  
Angela Kribs ◽  
Mathias Burgmaier ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Kidney Injury ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Daily Cycles ◽  
Good Clinical Condition ◽  
Increasing Demand

The outcome of extremely low-birth-weight (ELBW) and very low-birth-weight (VLBW) infants has substantially improved in recent years. As acute kidney injury is frequent in these infants due to various risk factors, there is an increasing demand for renal replacement therapy in these patients. Data on that topic, however, are scarce. We review the available literature on that topic and report our experience on temporary dialysis in three extremely immature infants (two ELBW and one VLBW) with acute kidney failure. Peritoneal dialysis (PD) was performed for 19, 23, and 44 days until recovery of native renal function. At recent follow-up of 18 and 24 months, two patients are in good clinical condition with chronic kidney disease stages 1 and 4, respectively. One patient deceased at the age of 12 months due to secondary liver failure. The dialysis regimen applied in our study differed significantly from older infants with extremely short dwell times and accordingly high numbers of daily cycles. The use of rigid acute PD catheters was associated with less catheter-related complications (leakage, dislocation, and obstruction) as compared to ascites drainage catheters. In summary, PD was technically feasible and effective also in extremely immature infants, but frequent adjustments of dialysis regimens and high numbers of daily cycles posed immense efforts on both, parents and medical staff.

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