Effective peritoneal dialysis in an infant with extensive resection of the small intestine

Acute renal failure and pulmonary edema developed in a 1-month-old baby with necrotizing enterocolitis and hypovolemic shock. Following resection of 93% of her small intestine and mesentery, peritoneal dialysis was started; it was terminated 96 h later with complete recovery of renal and pulmonary functions. Two weeks later, while on total parenteral nutrition, the infant developed fulminant septicemia and died. Postmortem examination showed normal kidneys. Surface measurement of the abdominal wall and viscera revealed that the actual peritoneal surface area of the patient was 671 cm2, only 44% of her calculated normal peritoneal surface area. We conclude that effective peritoneal dialysis is feasible in infants with acute renal failure even after marked reduction of the peritoneal surface area.