Acute kidney injury is a frequent complication for critical newborns. Its management is a significant challenge, especially in extremely low-birth-weight (ELBW) infants. Currently, peritoneal dialysis (PD) is the most manageable treatment. However, data are lacking regarding when diuresis can be declared irreversible relative to the start of PD. A female infant born at 28 + 0 weeks with a birth weight of 800 g by monochorionic diamniotic pregnancy, complicated by twin-to-twin transfusion syndrome, developed acute renal failure on the second day of life because of long-term intrauterine hypoperfusion. PD was started on day 7. The patient remained anuric until the 52nd day of dialysis, when she presented adequate urine output of 2.5 mL/kg/h and PD was suspended for 11 days. After an episode of sepsis, PD was re-started, and after 50 days of treatment, given a urine output of 1.5 mL/kg/h, it was discontinued. The patient died on day 132 after a disseminate infection, which led to multiorgan failure. In ELBW infants, PD is a valid therapeutic instrument to treat patients with renal failure. Despite the evidence of low renal functional reserve in these patients, the duration of recovery from diuresis after a period of anuria can be very long.

Gatto, A., Tiberi, E., Ferretti, S., Santoro, V., Piersanti, A., Paradiso, F. V., Nanni, L., Iezzi, R., Posa, A., Costa, S., Vento, G., An Interesting Case of Neonatal AKI: What Is the Time to Consider Anuria Irreversible?, <<CHILDREN>>, 2023; 10 (6): N/A-N/A. [doi:10.3390/children10061032] [https://hdl.handle.net/10807/304624]

An Interesting Case of Neonatal AKI: What Is the Time to Consider Anuria Irreversible?

Gatto, Antonio;Tiberi, Eloisa;Ferretti, Serena;Paradiso, Filomena Valentina;Nanni, Lorenzo;Iezzi, Roberto;Posa, Alessandro;Vento, Giovanni
2023

Abstract

Acute kidney injury is a frequent complication for critical newborns. Its management is a significant challenge, especially in extremely low-birth-weight (ELBW) infants. Currently, peritoneal dialysis (PD) is the most manageable treatment. However, data are lacking regarding when diuresis can be declared irreversible relative to the start of PD. A female infant born at 28 + 0 weeks with a birth weight of 800 g by monochorionic diamniotic pregnancy, complicated by twin-to-twin transfusion syndrome, developed acute renal failure on the second day of life because of long-term intrauterine hypoperfusion. PD was started on day 7. The patient remained anuric until the 52nd day of dialysis, when she presented adequate urine output of 2.5 mL/kg/h and PD was suspended for 11 days. After an episode of sepsis, PD was re-started, and after 50 days of treatment, given a urine output of 1.5 mL/kg/h, it was discontinued. The patient died on day 132 after a disseminate infection, which led to multiorgan failure. In ELBW infants, PD is a valid therapeutic instrument to treat patients with renal failure. Despite the evidence of low renal functional reserve in these patients, the duration of recovery from diuresis after a period of anuria can be very long.
2023
Inglese
Gatto, A., Tiberi, E., Ferretti, S., Santoro, V., Piersanti, A., Paradiso, F. V., Nanni, L., Iezzi, R., Posa, A., Costa, S., Vento, G., An Interesting Case of Neonatal AKI: What Is the Time to Consider Anuria Irreversible?, <<CHILDREN>>, 2023; 10 (6): N/A-N/A. [doi:10.3390/children10061032] [https://hdl.handle.net/10807/304624]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/304624
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