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Published on: February 2, 2021
Continuous renal replacement therapy for patients with acute kidney injury caused by melamine-related urolithiasis
Zi-Hao Yang1, Chen-Mei Zhang, Tao Liu
1Department 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.
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.
Conclusion:
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.
Insights
Continuous renal replacement therapy (CRRT) effectively treated acute kidney injury in infants with melamine-related kidney stones. CRRT rapidly improved renal function and clinical outcomes, avoiding invasive procedures.
Area of Science:
- Pediatric Nephrology
- Toxicology
- Critical Care Medicine
Background:
- 2008 epidemic of infant renal disease linked to melamine-contaminated milk.
- Acute kidney injury (AKI) in infants resulted from melamine-induced urolithiasis.
- Study focuses on 8 infants with AKI due to melamine-related stones.
Purpose of the Study:
- To retrospectively review the management of AKI in infants with melamine-related urolithiasis.
- Evaluate the effectiveness of continuous renal replacement therapy (CRRT) in this patient group.
Main Methods:
- Retrospective review of medical records for 8 infants with AKI.
- Analysis of demographic features, diagnosis, CRRT treatment, and patient outcomes.
- CRRT was administered in the pediatric intensive care unit.
Main Results:
- Pre-CRRT: Hypertension (6/8), oliguria/anuria, elevated BUN and creatinine.
- Post-CRRT: Decreased BUN, creatinine, and electrolyte levels.
- Clinical improvement in urine output and edema observed.
Conclusions:
- CRRT is an efficient treatment for AKI caused by melamine-related urolithiasis.
- CRRT rapidly improves renal function and avoids surgical interventions.
- CRRT offers a non-invasive approach to managing this specific type of AKI.
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