Bulletin de la Dialyse à Domicile · Published 2025-12-16 · DOI 10.25796/bdd.v8i4.87087
Background: Neonates with acute kidney injury (AKI) have a high risk of serious complications and mortality. For this population, peritoneal dialysis (PD) is often the best kidney replacement therapy (KRT) because it is straightforward, safe, and cost-effective, especially in settings with limited resources. Objective: To review the most recent data on the indications for PD in newborns, along with the associated techniques, the types of catheters available, the complications, and the outcomes. Methods: Recent studies and clinical experiences were examined to determine the effectiveness and safety of acute PD in neonatal intensive care units (NICUs). Results: The primary causes of neonatal PD are oliguric AKI, inborn errors of metabolism, and excessive fluid after cardiac surgery. It is preferable to use flexible catheters, such as the TenckhoffTM type, because they are associated with fewer complications. Most of the complications that have been reported are catheter leakage, blockage, peritonitis, and metabolic disorders like hyperglycemia. While mortality rates are still high, especially in premature infants and newborns with multiple organ failure, starting PD early could help improve survival and decrease the time spent on mechanical ventilation and in the NICU. In extremely low birth weight (ELBW) infants, PD is possible but challenging because of a higher risk of complications. Conclusion: PD remains an important part of neonatal KRT, especially in resource-limited countries. It is a simple, effective, and life-saving treatment for newborns with AKI, including preterm and ELBW infants. For improved outcomes, it is important to choose an appropriate catheter, start therapy early, and train local staff. In Morocco and other countries in which advanced KRT methods may not be widely available, promoting PD could be advantageous for both public health and clinical care.
Abstract from DOAJ. Public domain (CC0 1.0).
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