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Renal replacement therapy in the neonatal intensive care unit
Tze Yee Diane Mok1, Min-Hua Tseng2, Ming-Chou Chiang1
1Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch and School of Medicine, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan, ROC.
Pediatrics and Neonatology
|February 4, 2018
Summary
Renal replacement therapy (RRT) is feasible in critically ill neonates, including preterm infants. Continuous RRT (CRRT) demonstrated higher efficacy, especially for inborn errors of metabolism, with manageable complications.
Area of Science:
- Neonatal Intensive Care
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Renal replacement therapy (RRT) is increasingly vital for critically ill neonates.
- Limited data exists on RRT use within neonatal intensive care units (NICUs).
Purpose of the Study:
- To describe the utilization, efficacy, complications, and outcomes of RRT in a NICU.
- To evaluate RRT in neonates, including those with low birth weight and prematurity.
Main Methods:
- Retrospective study of 17 neonates requiring RRT from January 2009 to January 2017.
- Data collected included demographics, RRT mode (CRRT or PD), efficacy (BUN/metabolite reduction), complications, and clinical outcomes.
- Statistical analysis used chi-square and Mann-Whitney U tests.
Main Results:
- 12 neonates received CRRT, 5 underwent PD. Median gestational age was 37 weeks, median birth weight 2.7 kg.
- CRRT showed significant ammonia reduction (87.2%) in inborn errors of metabolism (IEM) and BUN reduction (33.7%) in non-IEM cases.
- Electrolyte disturbances were the primary complication; all IEM neonates survived, while non-IEM neonates had high mortality (78-80%).
Conclusions:
- RRT is feasible in neonates, including preterm and low birth weight infants.
- CRRT offers superior efficacy, particularly for IEM, with transient and correctable complications.
- Findings support RRT as a viable supportive therapy in the NICU setting.
Keywords:
acute kidney injurycontinuous renal replacement therapyinborn errors of metabolismneonatal intensive care unitperitoneal dialysisMore Related Videos
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