Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study
Abstract Background Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods In this retrospective cohort s...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-020-02092-1 |
| _version_ | 1818248948334198784 |
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| author | Jihyun Noh Chae Young Kim Euiseok Jung Joo Hoon Lee Young-Seo Park Byong Sop Lee Ellen Ai-Rhan Kim Ki-Soo Kim |
| author_facet | Jihyun Noh Chae Young Kim Euiseok Jung Joo Hoon Lee Young-Seo Park Byong Sop Lee Ellen Ai-Rhan Kim Ki-Soo Kim |
| author_sort | Jihyun Noh |
| collection | DOAJ |
| description | Abstract Background Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 h. Results Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%. Conclusions In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation. |
| first_indexed | 2024-12-12T15:28:42Z |
| format | Article |
| id | doaj.art-21560ac728544dd3be48d5cf9287be20 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-12T15:28:42Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-21560ac728544dd3be48d5cf9287be202022-12-22T00:20:10ZengBMCBMC Nephrology1471-23692020-10-012111910.1186/s12882-020-02092-1Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort studyJihyun Noh0Chae Young Kim1Euiseok Jung2Joo Hoon Lee3Young-Seo Park4Byong Sop Lee5Ellen Ai-Rhan Kim6Ki-Soo Kim7Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, Kyung Hee University School of MedicineDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterDepartment of Pediatrics, University of Ulsan College of Medicine, Asan Medical CenterAbstract Background Peritoneal dialysis (PD) has been used occasionally in extremely-low-birth-weight (ELBW) infants with acute kidney injury (AKI). This study aimed to evaluate the clinical characteristics and outcomes of ELBW infants with AKI treated with PD. Methods In this retrospective cohort study, the medical records of ELBW infants with AKI, who underwent PD from January 2008 to February 2018, were reviewed. A PD catheter (7.5–9.0 Fr) or central venous catheter (4 Fr) was used for the peritoneal access. Treatment with PD solutions (2.5 or 4.25%) was started at 10 mL/kg, which was increased to 20–30 mL/kg for 60–120 min/cycle continuing for 24 h. Results Twelve ELBW infants (seven male and five female infants) were treated, and their mean (±SD) gestational age and birth weight were 27.2 (±3.3) weeks and 706.5 (±220.5) g, respectively. Two patients had severe perinatal asphyxia (5-min Apgar score ≤ 3). The most important indication for starting PD was AKI due to sepsis. The average (±SD) duration of PD was 9.4 (± 7.7) days. The potassium levels in the ELBW infants with hyperkalemia decreased from 6.8 to 5.0 mg/mL after 9.3 (± 4.4) days. The most common complication of PD was mechanical dysfunction of the catheters, such as dialysate leakage (75%). Two patients were successful weaned off PD. The mortality rate of the infants treated with PD was 91.7%. Conclusions In this series, the mortality rate of ELBW infants with AKI treated with PD was relatively high because of their incompletely developed organ systems. Therefore, the use of PD should be carefully considered for the treatment of ELBW infants with AKI in terms of decisions regarding resuscitation.http://link.springer.com/article/10.1186/s12882-020-02092-1Acute kidney injuryInfantsExtremely low birth weightPeritoneal dialysisHyperkalemia |
| spellingShingle | Jihyun Noh Chae Young Kim Euiseok Jung Joo Hoon Lee Young-Seo Park Byong Sop Lee Ellen Ai-Rhan Kim Ki-Soo Kim Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study BMC Nephrology Acute kidney injury Infants Extremely low birth weight Peritoneal dialysis Hyperkalemia |
| title | Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study |
| title_full | Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study |
| title_fullStr | Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study |
| title_full_unstemmed | Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study |
| title_short | Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study |
| title_sort | challenges of acute peritoneal dialysis in extremely low birth weight infants a retrospective cohort study |
| topic | Acute kidney injury Infants Extremely low birth weight Peritoneal dialysis Hyperkalemia |
| url | http://link.springer.com/article/10.1186/s12882-020-02092-1 |
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