Peritoneal Dialysis in Extremely Low Birth Weight Baby using Chronic PD Catheter

Abstract

Acute kidney injury (AKI) and fluid overload are serious and common complication in premature babies and may increase morbidity and mortality. Renal replacement therapy should be considered for babies who fail medical interventions. Peritoneal dialysis (PD) is considered a safe and practical option for premature infants by producing efficient gentle removal of solutes and excessive water. There are few reports of PD done in extremely low birth weight (ELBW) infants. Acute PD catheters commonly used in children are reported to have more complications thus seldom used in premature babies. Several authors report using regular intravenous or central venous catheters to dialyze premature babies. We describe an ELBW (700g, twin A) infant born at 24 weeks gestation, who was dialyzed on the 34th day (910g) via pediatric size chronic PD catheter. Filling and drainage of PD fluid were performed manually. We encountered few complications and they were easily controlled. The dialysis resulted in normalization of serum creatinine and correction of fluid and electrolyte imbalance within 10 days. The infant continued to grow and eventually was discharged in good condition, with normal renal function at an adjusted age of 40 weeks (term).