the acute temporary peritoneal dialysis in neonates: a five-year experience

Background: the aim of this prospective study was to evaluate the characteristics of patients, treated by acute peritoneal dialysis (pd). we also assessed the indications for pd, pd-associated complications and neonatal outcomes in our patients. methods: during five years, 30 term newborns underwent temporary cycling pd. the procedure was performed by applying the manual technique. a straight and relatively rigid peritocat catheter (germany) was percutaneously inserted in neonates. statistical analysis was performed, using chi-square and student's t-test. results: all subjects were term newborns, including 16 females (52%) and 14 males (48%). in total, 16 cases (52%) were born via cesarean section. the average age and weight of neonates at catheter insertion were 15 days (range of 5-26 days) and 2800 g (range of 2300-4060 g), respectively. the mean pd duration was two days. there was no significant difference between gender, weight, mode of delivery and associated complications. in total, 74% of patients needed assisted ventilation. no case of death was reported due to catheter insertion; however, 12 patients (40%) died during pd. pd-related complications were reported in 70% of patients, and the most common complication was catheter outflow failure (14 cases, 46%). the underlying causes included inborn errors of metabolism (16 cases, 52%) and acute renal failure (14 cases, 48%). urea cycle enzyme defect, along with hyperammonemia, was the most common etiologic disease (9 cases). conclusion: pd is an effective treatment for seriously ill newborns with life-threatening conditions such as acute renal failure or certain inborn errors of metabolism. however, mortality rate remains high due to the severity of underlying diseases and comorbidities.