The Use of Acute Peritoneal Dialysis in Critically Ill Newborns.
BACKGROUND To evaluate the efficacy, complications, and mortality rate of acute peritoneal dialysis (APD) in critically ill newborns. MATERIAL AND METHODS The study included 31 newborns treated in our center between May 2012 and December 2014. RESULTS The mean birth weight, duration of peritoneal dialysis, and gestational age of the patients were determined as 2155.2 ± 032.2 g (580-3900 g), 4 days (1-20 days), and 34 weeks (24-40 weeks), respectively. The main reasons for APD were sepsis (35.5%), postoperative cardiac surgery (16%), hypoxic ischemic encephalopathy (13%), salting of the newborn (9.7%), congenital metabolic disorders (6.1%), congenital renal diseases (6.5%), nonimmune hydrops fetalis (6.5%), and acute kidney injury (AKI) due to severe dehydration (3.2%). APD-related complications were observed in 48.4% of the patients. The complications encountered were catheter leakages in nine patients, catheter obstruction in three patients, peritonitis in two patients, and intestinal perforation in one patient. The general mortality rate was 54.8%, however, the mortality rate in premature newborns was 81.3%. CONCLUSIONS APD can be an effective, simple, safe, and important therapy for renal replacement in many neonatal diseases and it can be an appropriate treatment, where necessary, for newborns. Although it may cause some complications, they are not common. However, it should be used carefully, especially in premature newborns who are vulnerable and have a high mortality risk. The recommendation of APD therapy in such cases needs to be verified by further studies in larger patient populations.
Department of Pediatrics, Division of Nephrology, Yuzuncu Yil University, School of Medicine, Van, Turkey.
Lokman
L
Ustyol
Department of Pediatrics, Division of Neonatology, Yuzuncu Yil University, School of Medicine, Van, Turkey.
Erdal
E
Peker
Department of Pediatrics, Division of Neonatology, Yuzuncu Yil University, School of Medicine, Van, Turkey.
Nihat
N
Demir
Department of Pediatric Surgery, Yuzuncu Yil University, School of Medicine, Van, Turkey.
Kemal
K
Agengin
Department of Pediatrics, Division of Neonatology, Yuzuncu Yil University, School of Medicine, Van, Turkey.
Oguz
O
Tuncer
D016638:Critical Illness / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D016019:Survival Analysis