Long Term Peritoneal Dialysis in an Anuric Preterm Infant – a Futile Treatment?

Abstract

The primarily anuric very low birth weight infant (VLBWI) is an ethical challenge for the attending doctor as well as for the parents. Long term peritoneal dialysis (PD) might provide an acceptable way in treating a primarily anuric VLBWI prior to kidney transplantation without endangering the child’s neurologic development. We report a case of a VLBWI born at 30 weeks gestational age after anhydramnion for 5 weeks. Postnatally the neonate had persisting anuria and was successfully treated with peritonealdialysis for 31 months followed by hemodialysis for 12 months and eventually received a renal transplantion at the age of 43 months.

Zusammenfassung

Das primär anurische Frühgeborene mit sehr niedrigem Geburtsgewicht (VLBWI) ist eine ethische Herausforderung für die betreuenden Ärzte und die Eltern des Kindes. Die Langzeitperitonealdialyse kann möglicherweise ein annehmbarer Weg für die Überbrückung bis zur Nierentransplantation sein, ohne die neurologische Entwicklung des Kindes zu gefährden. Wir berichten den Fall eines Frühgeborenen, das nach 5 Wochen Anhydramnion in der 30. Schwangerschaftswochen mit einer primären persistierenden Anurie geboren wurde. Das Kind wurde 31 Monate mit Peritonealdialyse behandelt und 12 Monate hämodialysiert, bis im Alter von 43 Monaten die Nierentransplantation erfolgte.

Key words

preterm infant - peritoneal dialysis - anuria - arterial hypotension - vasopressin

Schlüsselwörter

Frühgeburt - Peritonealdialyse - Anurie - arterielle Hypotension - vasopressin

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