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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

Growth and development of infants with end-stage renal disease receiving long-term peritoneal dialysis

B A Warady1, M Kriley, H Lovell

  • 1Department of Nephrology, Children's Mercy Hospital, Kansas City, Missouri 64108.

The Journal of Pediatrics
|May 1, 1988
PubMed

Insights

Early nutritional intervention and peritoneal dialysis in infants with end-stage renal disease (ESRD) can improve growth and development, despite some gross motor delays. This approach shows promise for better outcomes in affected infants.

Area of Science:

  • Pediatric Nephrology
  • Infant Development
  • Renal Disease Research

Background:

  • Infants with end-stage renal disease (ESRD) typically experience severe growth retardation and developmental delays.
  • Long-term peritoneal dialysis is a critical treatment for ESRD in infants.
  • Optimizing nutritional support is essential for managing ESRD in early life.

Purpose of the Study:

  • To evaluate the growth and neurodevelopmental outcomes of infants with ESRD undergoing long-term peritoneal dialysis.
  • To assess the impact of a tailored nutritional regimen on infant growth and blood urea nitrogen (BUN) levels.
  • To determine the effectiveness of early intervention strategies in improving developmental trajectories.

Main Methods:

  • Studied four infants with ESRD receiving peritoneal dialysis from before 4 weeks of age.
  • Implemented a nutritional regimen targeting appropriate weight gain and minimizing BUN.
  • Conducted neurodevelopmental evaluations (motor, cognitive, language, psychosocial) every 3 months.

Main Results:

  • At 1 year, mean height SDS was -1.33; weight for height was normal or elevated in all infants.
  • Mean caloric intake was 105 kcal/kg/d and protein intake was 2.7 g/kg/d, with a mean BUN of 53.6 mg/dL.
  • Three infants functioned in the normal developmental range, but all showed delayed gross motor skills.

Conclusions:

  • Early nutritional intervention and peritoneal dialysis can lead to improved growth and neurodevelopmental outcomes in infants with ESRD.
  • While overall development can be within the normal range, gross motor skills may remain a challenge.
  • These findings suggest that proactive management can mitigate some of the typical negative impacts of ESRD on infant development.

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