title: Acute peritoneal dialysis in neonates with acute kidney injury and hypernatremic dehydration.
abstract: OBJECTIVE
  We aimed to evaluate the efficacy of acute peritoneal dialysis (PD) and clinical outcomes in neonates with acute kidney injury (AKI) and hypernatremic dehydration. ♢
  
  
  METHODS
  The medical records of 15 neonates with AKI and hypernatremic dehydration who were treated with acute PD were reviewed. The diagnoses were AKI with hypernatremic dehydration with or without sepsis in 13 patients and AKI with hypernatremia and congenital nephropathy in 2 patients. The main indications for PD were AKI with some combination of oligoanuria, azotemia, hyperuricemia, and metabolic acidosis unresponsive to initial intensive medical treatment. ♢
  
  
  RESULTS
  The mean age of the patients at dialysis initiation was 11.9 ± 9 days, and the mean duration of PD was 6.36 ± 4.8 days. In 7 patients (46.7%), hypotension required the use of vasopressors, and in 6 patients (40%), mechanical ventilation was required. Peritoneal dialysis-related complications occurred in 7 patients (46.7%), the most common being catheter malfunction (n = 6). Four episodes of peritonitis occurred in the 15 patients (26.7%), 2 episodes in patients with congenital renal disease and 2 episodes in patients with sepsis and multiorgan failure, who did not survive. Congenital renal disease, septicemia, and the need for mechanical ventilation were important factors influencing patient survival. All patients with no pre-existing renal disease or sepsis recovered their renal function and survived. ♢
  
  
  CONCLUSIONS
  In neonates with AKI and hypernatremic dehydration, PD is safe and successful, and in patients without congenital renal disease or sepsis, the prognosis is good. Peritoneal dialysis should be the treatment of choice in neonates with AKI and hypernatremic dehydration who do not respond to appropriate medical treatment.
authors.affiliation: Department of Pediatric Nephrology, Göztepe Teaching and Research Hospital, Istanbul, Turkey. nurdan.yildiz@marmara.edu.tr
authors.forename: Nurdan
authors.initials: N
authors.lastname: Yildiz
authors.forename: Müferet
authors.initials: M
authors.lastname: Erguven
authors.forename: Metin
authors.initials: M
authors.lastname: Yildiz
authors.forename: Tutku
authors.initials: T
authors.lastname: Ozdogan
authors.forename: Pinar
authors.initials: P
authors.lastname: Turhan
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000150:complications; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000150:complications*; D007231:Infant, Newborn; D008297:Male; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D014883:Water-Electrolyte Imbalance / Q000628:therapy; D055815:Young Adult
keywords: Acute kidney injury; hypernatremic dehydration; neonates