Abstract
Acute renal injury is common in extremely low birth weight (ELBW) infants with a frequency ranging from 8% to 24%. Peritoneal dialysis (PD) has been used only occasionally in ELBW. We report our experience and share the solutions used to tackle the difficulties rising from the small size of this type of patients. PD was successfully performed in three ELBW infants with acute renal failure. A neonatal, single-cuff, straight Tenckhoff catheter was placed in 2 patients, while a Broviac single cuff vascular catheter was used in another. PD was feasible and effective in all children. Leakage was observed with Tenckhoff catheters, but this didn’t impair the PD efficacy. The technical difficulties were related to the size and shape of the peritoneal catheters, not easily fitting with the very thin abdominal wall of the preterm infants. We conclude that PD is feasible and effective, can be considered as the rescue therapy in preterm ELBW infants with acute renal failure.
Highlights
The frequency of acute renal failure (ARF) in extremely low birth weight (ELBW) infants ranges from 8% to 24% [1,2,3,4]
Ill neonates are at risk for acute kidney injury (AKI) as they have frequent infections and are exposed to nephrotoxic drugs [1, 4]
We report our experience on peritoneal dialysis (PD) in 3 ELBW infants with acute renal failure
Summary
The frequency of acute renal failure (ARF) in extremely low birth weight (ELBW) infants ranges from 8% to 24% [1,2,3,4]. Due to fluid overload (body weight of 830g on day 12) and persistent oliguria, unresponsive to diuretics, on the 10th day of life the infant became anuric, so that the decision of positioning a peritoneal catheter for dialysis was taken. Following the infectious complication and the treatment with Ceftazidime, a rapid deterioration of the renal function was observed Case 3: An out-born 1.097-g male, product of a monozygotic twin gestation complicated by twin-to-twin transfusion was referred to our Unit at the 19th day of life for oliguria, peripheral edema, massive weight gain (1.397-g) and congestive heart failure. The prenatal course was complicated by significant oligohydroamnios and growth retardation He was delivered at the 30 weeks gestation because of worsening of the cardiac function. Due to the severe renal parenchymal damage no recovery of renal function was observed and home PD was continued
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