Tian Zhen, Luo Xiu, Yang Hua, Ma Zhi-Mei, Yang Juan, Ji Yong-Jia
Department of Neonatology, PKUFH-NINGXIA Women & Children's Hospital, No.127 Lakeside Road, Jinfeng District, Yinchuan, Ningxia, 750001, China.
BMC Pediatr. 2025 Jan 7;25(1):15. doi: 10.1186/s12887-024-05352-3.
Neonates are prone to experiencing acute kidney injury (AKI) and metabolic irregularities. Although hemodialysis is a primary treatment for these conditions, its utilization is not prevalent in the Ningxia Autonomous Region in China. Peritoneal dialysis (PD) presents itself as an alternative with benefits such as simplicity, cost-effectiveness, and minimal technical complexity compared to hemodialysis. Nonetheless, the safety and efficacy of employing PD in neonates, particularly in very low birth weight infants, require additional investigation.
In this study, we explored the practical use of PD in neonates in the region of Ningxia.
The retrospective analysis focused on the clinical information of neonates undergoing PD at the neonatal intensive care unit of PKUFH-NINGXIA Women & Children's Hospital, covering the period from January 2021 to August 2023.
A total of 7 neonates (3 males and 4 females) were included in the study, including one early preterm infant (28-31 weeks' gestational age), one moderately preterm infant (32-33 weeks' gestational age), two late preterm infants (34-36 weeks' gestational age), and three term infants. The minimum gestational age recorded was 28 + 6 weeks and the lowest body weight was 1,075 g. Among the cases, sepsis was the primary cause of AKI in three cases (43%), with preterm infants accounting for 67% of these cases; genetic metabolic disorder in two cases (28.5%), and twin-twin transfusion syndrome in two cases (28.5%), both involving premature infants; and one of these two involving severe asphyxia. The onset of dialysis occurred between 1 and 24 days of age, and the duration of dialysis ranged from 1 to 5 days. The dialysis procedures for all seven cases were executed smoothly, and there were no complications observed in terms of unsecured catheter leakage at the insertion site, hyperglycemia, hypokalemia, catheter occlusion, peritonitis, or catheter detachment during the peritoneal dialysis treatment.
The use of peritoneal dialysis proves to be a safe and efficient approach in addressing neonatal AKI.
新生儿易发生急性肾损伤（AKI）和代谢紊乱。尽管血液透析是这些病症的主要治疗方法，但在中国宁夏回族自治区，其应用并不普遍。与血液透析相比，腹膜透析（PD）具有操作简单、成本效益高和技术复杂度低等优点，是一种替代选择。然而，在新生儿尤其是极低出生体重儿中应用PD的安全性和有效性仍需进一步研究。
本研究探讨了PD在宁夏地区新生儿中的实际应用情况。
回顾性分析了2021年1月至2023年8月期间在北京大学第一医院宁夏妇女儿童医院新生儿重症监护病房接受PD治疗的新生儿的临床资料。
本研究共纳入7例新生儿（3例男性，4例女性），其中包括1例极早早产儿（胎龄28 - 31周）、1例中度早产儿（胎龄32 - 33周）、2例晚期早产儿（胎龄34 - 36周）和3例足月儿。记录到的最小胎龄为28⁺6周，最低体重为1075克。其中，败血症是3例（43%）AKI的主要原因，早产儿占这些病例的67%；遗传代谢紊乱2例（28.5%），双胎输血综合征2例（28.5%），均涉及早产儿，其中1例还伴有重度窒息。透析开始于出生后1至24天，透析持续时间为1至5天。7例患儿的透析过程均顺利，腹膜透析治疗期间未观察到插管部位导管渗漏、高血糖、低钾血症、导管堵塞、腹膜炎或导管脱落等并发症。
腹膜透析是治疗新生儿AKI的一种安全有效的方法。
