Paediatria Croatica
Kad bubrezi zataje na samom početku života: Prikaz slučaja novorođenčeta na peritonejskoj dijalizi i hemodijalizi
By Marina Perla.
Abstract
Objective
To present the complex treatment course of a neonate with early-onset kidney failure requiring kidney replacement therapy from the fifth day of life and to highlight the importance of adapting dialysis modalities, nursing monitoring, and parental education.
Case report
A male neonate was born at 38 + 3 weeks of gestation with prenatally diagnosed anhydramnios, bilateral hydronephrosis, cardiomegaly, and bowel distension. On the third day of life, he was transferred from the Department of Obstetrics and Gynecology to the Department of Nephrology, Dialysis and Transplantation and subsequently, due to severe hyponatremia, to the Neonatal Intensive Care Unit. Because of oliguria and increasing serum urea and creatinine concentrations, kidney replacement therapy was initiated on the fifth day of life. Continuous ambulatory peritoneal dialysis and automated peritoneal dialysis were used, as well as continuous veno-venous hemodiafiltration during periods of hypervolemia and clinical instability. The clinical course was complicated by peritoneal catheter dysfunction requiring multiple surgical revisions, central venous catheter thrombosis, sepsis, arterial hypertension, and status epilepticus. Following clinical and nutritional stabilization and structured parental training, the infant was discharged home on automated peritoneal dialysis.