Acute Peritoneal Dialysis System for Neonates with Acute Kidney Injury Requiring Renal Replacement Therapy: A Case Series

Perit Dial Int. 2018 Dec;38(Suppl 2):S45-S52. doi: 10.3747/pdi.2018.00109. Epub 2018 Oct 12.

Abstract

Background: Acute kidney injury (AKI) is common in critically ill neonates, and peritoneal dialysis (PD) can be a lifesaving option. In China, however, much of the equipment for PD in neonates is not available. We describe results with a novel system for PD, which has been developed locally to improve access to therapy and care for critically ill neonates requiring PD in China.

Methods: The system comprises a 14-gauge single-lumen central venous catheter serving as a PD catheter, inserted by Seldinger technique, with an adapted twin bag PD system. Ten neonates with AKI were treated using the novel PD system.

Results: The 10 patients ranged in age from 1 day to 22 days, with bodyweights between 700 g and 3,300 g. Average time to renal function recovery was between 14 and 96 hours. Complications related to the novel PD system included leak (n = 1), catheter displacement (n = 1), and catheter obstruction (n = 1). There were no complications related to insertion, no cases of peritonitis or exit-site infection, and no subsequent hernias. A comparison of costs indicated that the novel PD system is less expensive than conventional systems involving open insertion of Tenckhoff catheters.

Conclusions: Peritoneal dialysis using the novel PD system is simple, safe, and effective for suitable neonates with AKI in China.

Keywords: AKI; Improved PD system; central venous catheter.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / mortality*
  • Acute Kidney Injury / therapy*
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Catheters, Indwelling / adverse effects
  • China
  • Critical Illness / mortality
  • Critical Illness / therapy
  • Databases, Factual
  • Equipment Design
  • Equipment Safety
  • Female
  • Hospitals, General
  • Humans
  • Infant, Newborn
  • Male
  • Peritoneal Dialysis / adverse effects*
  • Peritoneal Dialysis / instrumentation
  • Peritoneal Dialysis / methods*
  • Renal Replacement Therapy / methods
  • Retrospective Studies