Acute kidney injury and peritoneal dialysis in extremely low birth weight newborns

Kaya, Hüseyin; Gökçe, İsmail Kürşat; Turgut, Hatice; Оздемир, Рамазан; Tabel, Yılmaz

doi:10.23736/s0026-4946.20.05617-0

Cited by 3 publications

(1 citation statement)

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“…Then, 23 articles were retrieved as full-texts. Of them, two studies 23,24 were excluded for not providing individual participant data and another one 25 was not included as the follow-up period was not available. As a result, the present meta-analysis was based on 20 studies, 26,27,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] comprising 101 infants (27 VLBW and 74 ELBW).…”

Section: Study Selectionmentioning

confidence: 99%

Peritoneal dialysis in very low and extremely low birthweight infants: A pooled analysis

Bellos

Karageorgiou

2021

Perit Dial Int

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Background: Peritoneal dialysis (PD) represents an important therapeutic option in neonatal acute kidney injury (AKI), although evidence regarding its effects in preterm neonates remains unclear. The present study aims to evaluate the feasibility of PD in very low birthweight (VLBW) and extremely low birthweight (ELBW) infants and clarify the association of catheter choice with clinical outcomes. Methods: Medline, Scopus, Web of Science, Clinicaltrials.gov and CENTRAL databases were systematically searched from inception to 15 January 2021. Studies reporting individual participant data of VLBW and ELBW infants treated with PD were selected. Results: Overall, 20 studies were included comprising 101 patients. Catheter-related complications were significantly more frequent among ELBW infants (odds ratio: 5.18, 95% confidence intervals (CI): 1.23–29.09). After inverse probability treatment weighting, compared to drainage catheters, death risk was significantly lower with the use of PD (hazard ratio: 0.42, 95% CI: 0.19–0.90) but not vascular catheters (hazard ratio: 0.58, 95% CI: 0.28–1.20). Similarly, kidney function loss was significantly lower only with the implementation of PD catheters (hazard ratio: 0.44, 95% CI: 0.21–0.94). Conclusions: PD is a feasible kidney replacement therapy modality in VLBW and ELBW infants with AKI. The use of drainage catheters may be linked to significantly worse kidney recovery and overall survival rates, compared to PD catheters. Future cohorts should confirm the most appropriate catheter type and contribute to the standardisation of PD procedures.

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Section: Study Selectionmentioning

confidence: 99%

Peritoneal dialysis in very low and extremely low birthweight infants: A pooled analysis

Bellos

Karageorgiou

2021

Perit Dial Int

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Acute kidney injury in premature and low birth weight neonates: a systematic review and meta-analysis

Wang

Pei

et al. 2021

Pediatr Nephrol

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Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

et al. 2020

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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.

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Acute kidney injury and peritoneal dialysis in extremely low birth weight newborns

Cited by 3 publications

References 0 publications

Peritoneal dialysis in very low and extremely low birthweight infants: A pooled analysis

Peritoneal dialysis in very low and extremely low birthweight infants: A pooled analysis

Acute kidney injury in premature and low birth weight neonates: a systematic review and meta-analysis

Challenges of acute peritoneal dialysis in extremely-low-birth-weight infants: a retrospective cohort study

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