Continuous renal replacement therapy for patients with acute kidney injury caused by melamine-related urolithiasis.
BACKGROUND
In 2008 there was an epidemic of renal disease affecting infants after consumption of melamine-tainted milk products. Most of the infected children were asymptomatic or with mild symptoms, and a few suffered from acute obstructive kidney injury secondary to melamine-contained renal stones (8 of 15,577 children screened at our hospital for urolithiasis). This study was intended to retrospectively review the management of acute kidney injury using continuous renal replacement therapy (CRRT) in the 8 children with acute kidney injury.


METHODS
The 8 infants with acute kidney injury caused by melamine-related urolithiasis were referred to the pediatric intensive care unit at the hospital in late 2008. CRRT was given to treat their kidney injuries. Medical records of the infants were reviewed for demographic features, diagnosis, CRRT treatment, and outcomes.


RESULTS
Before CRRT, hypertension was found in 6 of the 8 children. Varying degrees of oliguria, anuria, elevated levels of blood urea nitrogen (BUN) (13.11-35.6 mmol/L) and creatinine (Cr) (238.8-773.7 mumol/L) were observed in these patients. After CRRT, the levels of BUN, Cr and electrolytes decreased. Urine output and edema were improved clinically.


CONCLUSIONS
CRRT can rapidly improve renal function, avoiding such surgical interventions as lithotripsy, percutaneous nephrolithotomy, and ureteroscopy. It is an efficient modality to treat acute kidney injury caused by melamine-related urolithiasis.
Yang
Zi-Hao
ZH
Department of Pediatric ICU, Children's Hospital of Zhejiang University School of Medicine and Zhejiang Key Laboratory for Diagnosis and Therapy of Neonatal Diseases, Hangzhou, 310003, China.
Zhang
Chen-Mei
CM
Liu
Tao
T
Lou
Xiao-Fang
XF
Chen
Zhen-Jie
ZJ
Ye
Sheng
S
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D001002:Anuria / Q000209:etiology / Q000628:therapy; D001806:Blood Urea Nitrogen; D002675:Child, Preschool; D003404:Creatinine / Q000032:analysis; D005260:Female; D006440:Hemofiltration; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology / Q000628:therapy; D006973:Hypertension / Q000209:etiology / Q000628:therapy; D007223:Infant; D041943:Infant Formula / Q000737:chemistry; D015278:Intensive Care Units, Pediatric; D008297:Male; D009846:Oliguria / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D014227:Triazines / Q000009:adverse effects* / Q000032:analysis; D052878:Urolithiasis / Q000139:chemically induced* / Q000150:complications / Q000628:therapy
D014227:Triazines; D003404:Creatinine; C011907:melamine