A CLINICAL CASE OF CONTINUOUS FLOW PERITONEAL DIALYSIS IN A ONE-MONTH OLD CHILD WITH ACUTE RENAL DAMAGE AND NECROTIZING ENTEROCOLITIS



Cite item

Full Text

Abstract

Necrotizing enterocolitis of newborns (NEC) is a severe intestinal disease that occurs against the background of acute hypoxia, violations of normal colonization of the intestine by microflora, leading to necrosis and perforation of the intestinal wall, peritonitis. Frequency of occurrence of 1-5 cases per 1000 live-born children. Most often, premature babies and children with low birth weight get sick. The development of NEC in a child significantly worsens the prognosis and increases mortality. Modern development of medical technology has made it possible to provide assistance to extremely premature newborns, which has led to an increase in the number of patients with NEC who are in a critical condition due to the course of multi-organ failure, including kidney failure, which requires renal replacement therapy (RRT). The main method of RRT used in newborns and young children is peritoneal dialysis (PD). NEC in the initial stages is considered an absolute contraindication for performing invasive manipulations on the abdominal cavity, since the risk of disease progression with the development of complications requiring surgical intervention increases at times. Recently, peritoneal dialysis has also become widespread in deeply premature newborns, who are the main risk group for developing NEC. Peritoneal dialysis in the continuous flow modification eliminates high intra-abdominal tension, one of the provoking factors for the progression of NEC, and in foreign expert studies, there are reports that the dialysis solution improves the intestinal wall trophism. This article presents a clinical case of peritoneal dialysis in flow modification in a 1-month-old child with acute renal damage and necrotizing enterocolitis.

About the authors

M. G. Rekhviashvili

Speransky Children’s Municipal Clinical Hospital No 9; Morozov Children’s City Clinical Hospital

Author for correspondence.
Email: dr.rekhviashvili@yandex.ru
ORCID iD: 0000-0003-2256-6198
Россия

A. I. Makulova

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0001-9952-3159
Россия

A. B. Chashchukhina

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0003-0388-3921
Россия

O. Yu. Brunova

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0003-2158-6672
Россия

Yu. I. Kucherov

Speransky Children’s Municipal Clinical Hospital No 9; Pirogov Russian National Research Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0001-7189-373X
Россия

N. M. Zaykova

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0002-8166-2449
Россия

T. V. Ivashkina

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0002-2173-3946
Россия

N. P. Wainstein

Speransky Children’s Municipal Clinical Hospital No 9; Pirogov Russian National Research Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0002-9750-0719
Россия

A. A. Korsunsky

Speransky Children’s Municipal Clinical Hospital No 9

Email: noemail@neicon.ru
ORCID iD: 0000-0003-1201-0073
Россия

References

  1. Козлов Ю.А., Новожилов В.А., Ковальков К.А., Чубко Д.М., Барадиева П.Ж., Тимофеев А.Д., Ус Г.П., Кузнецова Н.Н. Некротизирующий энтероколит у новорожденных. Новые взгляды и тенденции. Детская хирургия. 2016; 20(4):188-93
  2. Sánchez C., García M.A., Valdés B.D. Acute kidney injury in newborns with necrotizing enterocolitis: risk factors and mortality. Bol Med Hosp Infant Mex. 2019; 76(5): 210-4.
  3. Bakhoum C.Y., Basalely A., Koppel R.I., Sethna C.B. Acute kidney injury in preterm infants with necrotizing enterocolitis. J Matern Fetal Neonatal Med. 2019 Oct; 32(19): 3185-90.
  4. El-Badawy A.A., Makar S.1., Abdel-Razek A.R., Abd Elaziz D. Incidence and risk factors of acute kidney injury among the critically ill neonates. Saudi J Kidney Dis Transpl. 2015 May-Jun;.26(3): 549-55.
  5. Sevim Unal, Leyla Bilgin, Mehmet Gunduz, Nermin Uncu, Mujdem Nur Azili, Tugrul Tiryaki. The implementation of neonatal peritoneal dialysis in a clinical setting. The Journal of Maternal-Fetal and Neonatal Medicine. 2012; 25(10): 2111-211.
  6. Sanchez-de-Toledo J., Perez-Ortiz A., Gil L., Baust T., Linés-Palazón M., Perez-Hoyos S., Gran F., Abella R.F. Early Initiation of Renal Replacement Therapy in Pediatric Heart Surgery Is Associated with Lower Mortality. Pediatr Cardiol. 2016 Apr; 37(4): 623-8.
  7. Picca S., Dionisi-Vici C., Abeni D., Pastore A., Rizzo C., Orzalesi M., Sabetta G., Rizzoni G., Bartuli A. Extracorporeal dialysis in neonatal hyperammonemia: modalities and prognostic indicators. Pediatric Nephrology. 16(11): 862-7. ГОД?
  8. Cory N. Criss, David T. Selewski, Bipin Sunkara, Joshua S. Gish, Lily Hsieh, Jennifer S. Mcleod, Jason O. Robertson, Niki Matusko, Samir K. Gadepalli. Acute kidney injury in necrotizing enterocolitis predicts mortality. Pediatric Nephrology. 2018 March; 33(3): 503-10.
  9. Kaddourah A., Goldstein S.L. Renal replacement therapy in neonates. ClinPerinatol. 2014 Sep; 41(3): 517-27.
  10. Zarbock A., Kellum J.A., Schmidt C., Van Aken H., Wempe C., Pavenstädt H., Boanta A., Gerß J., Meersch M. Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury: The ELAIN Randomized Clinical Trial. JAMA. 2016 May; 24-31; 315(20): 2190-9.
  11. Selewski D.T., Goldstein S.L. The role of fluid overload in the prediction of outcome in acute kidney injury. Pediatr Nephrol. 2018 Jan; 33(1): 13-24.
  12. Lee S.T., Cho H. Fluid overload and outcomes in neonates receiving continuous renal replacement therapy. Pediatr Nephrol. 2016; 31: 2145-52.
  13. Писклаков А.В., Федоров Д.А., Новиков Б.М. Опыт лечения новорожденных с некротизирующим энтероколитом с учетом показателей внутрибрюшного давления (предварительное сообщение). Детская хирургия. 2012; 2: 27-9
  14. Hatice Sonay Yalcin, Haluk Sarihan, Ismail Saygin, Mustafa Imamoglu, Dilek Basar, Gamze Can. Еffects of peritoneal dialysis solution on experimental necrotizing enterocolitis in newborn rats. SN Comprehensive Clinical Medicine. 2019 July; 1(7): 547-51

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2020

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies