Department of Neonatology, Cleveland Clinic Children's, Cleveland, OH, USA.
Department of Pediatrics, Michigan State University/Sparrow Health System, Lansing, MI, USA.
Pediatr Nephrol. 2023 Mar;38(3):867-876. doi: 10.1007/s00467-022-05575-5. Epub 2022 Jul 5.
We aimed to assess prevalence and clinical characteristics of newborns receiving kidney replacement therapy (KRT).
We used the National Inpatient Sample (NIS) dataset for the years 2000-2017. Newborns treated with peritoneal dialysis (PD), hemodialysis (HD), and continuous KRT (CKRT) were included. Trend analysis using the Cochran-Armitage test was used to assess prevalence over the years.
A total of 64,532,552 hospitalized newborns were included. Among the 4281 infants treated with KRT, 2501 (58.4%) were treated with PD, 997 (23.3%) had HD, and 783 (18.3%) used CKRT. Associated diagnoses included congenital kidney anomalies (37.4% vs. 15% vs. 9.5%), urinary tract anomalies (35% vs. 12.5% vs. 6.3%), and congenital heart disease (68% vs. 25.7% vs. 72.3%). Median length of stay was longest in PD patients (39 days vs. 18 days vs. 26 days), respectively. However, cost of hospitalization was greatest in CKRT patients (US $490,916 vs. US $218,514 vs. US $621,554), respectively. In the entire cohort, 54,424 newborns had acute kidney injury (AKI); of them 16,999 (31%) died. KRT was used in 2,688 (4.9%) of infants with AKI. Over the study period, trends for utilization of PD (from 0.042 to 0.06%) and CKRT (from 0.03 to 0.21%) increased whereas the hemodialysis trend decreased (from 0.021 to 0.013%).
Congenital heart disease (CHD) and congenital anomalies of the kidneys and urinary tract (CAKUT) are the major diagnoses in newborns receiving KRT. Utilization of PD was greater than HD and CKRT. Trends of PD and CKRT utilization increased over time. Less than 5% of infants diagnosed with AKI received KRT.
我们旨在评估接受肾脏替代治疗（KRT）的新生儿的患病率和临床特征。
我们使用了 2000 年至 2017 年的国家住院患者样本（NIS）数据集。纳入接受腹膜透析（PD）、血液透析（HD）和连续肾脏替代治疗（CKRT）治疗的新生儿。使用 Cochran-Armitage 检验进行趋势分析，以评估多年来的患病率。
共纳入 6453252 例住院新生儿。在 4281 例接受 KRT 治疗的婴儿中，2501 例（58.4%）接受 PD 治疗，997 例（23.3%）接受 HD 治疗，783 例（18.3%）接受 CKRT 治疗。相关诊断包括先天性肾脏异常（37.4%比 15%比 9.5%）、尿路异常（35%比 12.5%比 6.3%）和先天性心脏病（68%比 25.7%比 72.3%）。PD 患者的中位住院时间最长（39 天比 18 天比 26 天），但 CKRT 患者的住院费用最高（分别为 490916 美元、218514 美元和 621554 美元）。在整个队列中，54424 例新生儿患有急性肾损伤（AKI）；其中 16999 例（31%）死亡。AKI 患儿中有 2688 例（4.9%）接受了 KRT 治疗。在研究期间，PD（从 0.042 到 0.06%）和 CKRT（从 0.03 到 0.21%）的使用趋势增加，而血液透析的趋势下降（从 0.021 到 0.013%）。
先天性心脏病（CHD）和先天性肾和尿路异常（CAKUT）是接受 KRT 治疗的新生儿的主要诊断。PD 的使用率高于 HD 和 CKRT。PD 和 CKRT 的使用趋势随时间增加。不到 5%的 AKI 诊断婴儿接受了 KRT 治疗。
