title: The implementation of neonatal peritoneal dialysis in a clinical setting.
abstract: OBJECTIVE
  To investigate etiology, outcome and complications related to neonatal peritoneal dialysis (PD).
  
  
  METHODS
  Neonates treated with PD in our neonatal intensive care unit during 2007-2010 were analyzed retrospectively.
  
  
  RESULTS
  Among 4036 hospitalized neonates; 20 neonates (0.5%) who underwent 21 cycles of PD [7 preterm, 13 term; 13 female, 7 male] were included. The mean birth weight was 2930.2 ± 720.6 g (1120-4570), mean gestational age was 37.5 ± 3.5 weeks (27-41). The etiologic disorders included inborn errors of metabolism (propionic acidemia, methylmalonic acidemia, citrullinemia, glutaric aciduria type 2, maple syrup urine disease, 10), or acute renal failure secondary to perinatal asphyxia (4), sepsis (2), prematurity (2), hypoplastic left heart syndrome (1), kernicterus (1). The complications included peritonitis (2), early leakage (4), hemorrhage (1), catheter removal (3) and occlusion (2). The mortality rate was 50%. The gestational ages and birth weights of surviving neonates were higher (p < 0.05). Among surviving neonates, chronic renal failure (1), severe (4) and moderate neuromotor impairment (2) developed within 4-43 months.
  
  
  CONCLUSIONS
  PD, although invasive, is an effective therapy in neonates. The complexity and invasiveness of the procedure is probably responsible for high rate of complications and mortality. If appropriate catheter selection and technique in the placement should be done, PD might improve outcome.
authors.affiliation: Department of Neonatology, Ankara Children's Health Hematology Oncology Research Hospital, Ankara, Turkey. sevimunal@yahoo.com
authors.forename: Sevim
authors.initials: S
authors.lastname: Unal
authors.forename: Leyla
authors.initials: L
authors.lastname: Bilgin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gunduz
authors.forename: Nermin
authors.initials: N
authors.lastname: Uncu
authors.forename: Mujdem Nur
authors.initials: MN
authors.lastname: Azili
authors.forename: Tugrul
authors.initials: T
authors.lastname: Tiryaki
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D008661:Metabolism, Inborn Errors / Q000401:mortality / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome