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Minerva Pediatrica 2020 Jun 02

DOI: 10.23736/S0026-4946.20.05617-0


language: English

Acute kidney injury and peritoneal dialysis in extremely low birth weight newborns

Huseyin KAYA 1 , İsmail K. GOKCE 1, Hatice TURGUT 1, Ramazan ÖZDEMIR 1, Yılmaz TABEL 2,

1 Division of Neonatology, Department of Pediatrics, Turgut Ozal Medical Center, Inonu University School of Medicine, Malatya, Turkey; 2 Division of Pediatric Nephrology, Department of Pediatrics, Turgut Ozal Medical Center, Inonu University School of Medicine, Malatya, Turkey


BACKGROUND: In 12.5-56% of extremely low birth weight (ELBW) infants treated in newborn units, acute kidney injury (AKI) develops. Some of these infants may need renal replacement therapy for reasons including hyperkalemia, hypovolemia and resistant acidosis.
METHODS: All ELBW infants who were followed in our hospital between January 2015 and December 2017 and who lived longer than 48 hours were assessed. Patients were followed for AKI and peritoneal dialysis (PD).
RESULTS: AKI developed in 25 of 201 ELBW infants. PD was administered to nine patients. PD was initiated at a median of 11 days (2-22 days) for all patients due to hyperkalemia which did not respond to medical treatment. Three of the nine infants who received PD died while dialysis was ongoing. The remaining six patients completed PD successfully. In these patients, the serum potassium value returned to normal in three days, and dialysis was continued for a median of 93 hours (40-172 hours). Dialysis leakage occurred in two patients, and hyperglycemia developed in two patients. On average, diuresis started at the 25th hour (8-40th hour).
CONCLUSIONS: In the renal failure treatment of ELBW infants, PD is the only option which can be used for many units. It was found that in ELBW infants who had wider peritoneal surface when compared to their body weight, biochemical values recovered rapidly with PD, and diuresis started a short while later in most patients.

KEY WORDS: Premature; Hyperkalemia; Renal failure; Renal replacement therapy

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