An Efficient Method For Renal Replacement Therapy In Newborn: Acute Peritoneal Dialysis

Öz

Aim: The aim is to evaluate the etiology, methods, events, complications and success rates of acute peritoneal dialysis at neonatal periodMaterial And Methods: Newborn babies, who had been diagnosed with different indications for dialysis and peritoneal dialysis was applied in the Intensive Care Unit, were evaluated retrospectively. A total of 44 infants were included in the study. Patients were evaluated according to the demographic, clinical and laboratory findings, etiology, efficacy and complications and the relationship between these findings and survival rate was compared.Results: Leukocyte count, pH and HCO3 values determined at the application, primary diagnosis, follow-up ventilator requirements, development of peritonitis and daily amount of ultrafiltrate were significantly correlated with survivalrates. There was no significant relationship in terms of otherdata.Conclusion: Applications of acute peritoneal dialysis in the newborn period can be performed for acute kidney injury and metabolic disorders unresponsive to medical treatment and it is a simple, safe and effective method.

Anahtar Kelimeler

• Complication,newborn,peritoneal dialysis

Yenidoğan Döneminde Etkin Bir Renal Replasman Tedavisi Yöntemi: Akut Periton Diyalizi

Öz

Amaç: Yenidoğan döneminde akut periton dializi uygulamasının etiyoloji, yöntem, etkinlik, komplikasyon ve başarı oranlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Yenidoğan Yoğun Bakım Ünitesi’nde farklı tanılarla diyaliz endikasyonu konulan ve periton diyalizi uygulanan bebekler retrospektif olarak değerlendirildi. Çalışmaya toplam 44 bebek dahil edildi. Olgular demografik özellikler, klinik, laboratuvar bulguları, etiyoloji, etkinlik, komplikasyon açısından değerlendirilerek sağkalım ile bu bulgular arasındaki ilişki karşılaştırıldı.Bulgular: Başvuruda saptanan lökosit sayısı, pH ve HCO3 değerleri, primer tanı, izlemde ventilatör gereksinimi, peritonit gelişimi ve günlük ultrafiltrat miktarları ile sağkalım oranları arasında anlamlı ilişki saptandı. Diğer veriler açısından anlamlı ilişki saptanmadı.Sonuç: Akut periton diyaliz uygulamaları yenidoğan döneminde akut böbrek hasarı ve medikal tedaviye yanıtsız metabolik bozukluklarda uygulanabilen basit, güvenli ve etkin bir yöntemdir.

Anahtar Kelimeler

• Komplikasyon,periton diyalizi,yenidoğan

Kaynakça

1. Lee MM, Chua AN, Yorgin PD. Neonatal peritoneal dialysis. Neoreviews 2005;8:384–391
2. Korbet, SM. Acute Peritoneal Dialysis Prescription. In: Daugirdas, JT, Blake, PG (eds) . Handbook of Dialysis, 4th, , Ing, TS (Eds), Lippincott Williams & Wilkins, Philadelphia 2007.
3. Warady BA, Feneberg R, Verrina E, Flynn JT, Müller-Wiefel DE, Besbas N, et al. IPPR. Peritonitis in children who receive long-term peritoneal dialysis: a prospective evaluation of therapeutic guidelines. J Am Soc Nephrol.2007;18:2172-9.
4. Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, et al.Consensus guidelines for the prevention and treatment of catheter-re- lated infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int. 2012 Jun;32 Suppl 2:S32-86.
5. Khanna R, Krediet R.T. Nolphand Gokal’sTextbook of Peritoneal Dialysis. Third edition. Springer-Verlag New York.2008
6. Toth-Heyn P, Drukker A, Guignard JP. The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephro- pathy. Pediatr Nephrol 2000;14:227-239.
7. Guignard JP, Gouyon JB, John EG. Vasoactive factors in the immature kidney. Pediatr Nephrol 1991;5:443-6.
8. Seri I, Evans J, Tulassay T. Renal insufficiency and acute renal failure. In: Taeusch HW, Ballard RA (Eds), 1998 Avery’sDiseases of the Newborn, 7th edition. WB Saunders Company,1158-1164.

9. Hentschel R, Lödige B, Bulla M. Renal in sufficiency in the neonatal peri- od. Clin Nephrol 1996;46:54-8.
10. Gong WK, Tan TH, Foong PP, Murugasu B, Yap HK. Eighteen years ex- perience in pediatric acute dialysis: analysis of predictors of outcome. Pediatr Nephrol 2001;16:212–215
11. Goldstein SL, Somers MJ, Baum MA, Symons JM, Brophy PD, Blowey D,et al.Pediatric patients with multi-organ dysfunction syndrome recei- ving continuous renal replacement therapy. Kidney Int. 2005;67:653-8.
12. Jones AS, James E, Bland H, Groshong T. Renal failure in the newborn. Clin Pediatr (Phila) 1979;18:286–287, 291
13. Hakan N, Aydin M, Zenciroglu A, Aydog O, Erdogan D, Karagol BS, et al. Acute peritoneal dialysis in the newborn period: a 7-year single-center experience at tertiary neonatal intensive care unit in Turkey. Am J Perina- tol.2014;31:335-8.
14. Matthews DE, West KW, Rescorla FJ, et al. Peritoneal dialysis in the first 60 days of life. J Pediatr Surg 1990;25:110–115.
15. Blowey DL, McFarland K, Alon U, McGraw-Houchens M, Hellerstein S, Warady BA. Peritoneal dialysis in the neonatal period: out come data. J Perinatol 1993;13:59–64
16. Kendirli T, Ekim M, Ozçakar ZB, Yüksel S, Acar B, Oztürk-Hiişmi B,et al. Renal replacement therapies in pediatric intensive care patients: expe- riences of one center in Turkey. Pediatr Int. 2007;49:345-8.