Review: Neonatal dialysis is technically feasible but ethical and global issues need to be addressed. The authors retrospectively reviewed all neonates who received dialysis in their French paediatric and neonatal intensive care units 2009-2019 and the published literature. They noted that dialysis is performed on neonates with pre-existing renal diseases, acute kidney injuries or inborn errors of metabolism. It is required in 0.5%-1% of neonates admitted to the neonatal intensive care units. Peritoneal dialysis and extracorporeal blood purification are both feasible, with some complications, and novel haemodialysis machines are being evaluated. However, the treatment is ethically challenging, and short-term and long-term data remain limited. Prospective studies and dialysis registries would improve global management and quality of life of these patients at risk of chronic kidney disease.
Neonatal acute kidney injury: a case-based approach. Neonatal acute kidney injury (AKI) is increasingly recognized in critically ill neonates. Many factors contribute to an increased risk of AKI in neonates, including the low nephron mass and immature tubular function, which result in the low glomerular filtration rates. There are also challenges with using serum creatinine as a marker of kidney function in newborns. The best approach to treatment in such patients may include diuretic therapies or kidney support therapy. Data for long-term outcomes are limited but suggest an increased risk of chronic kidney disease (CKD) and hypertension in these infants.
Neonatal Renal Tumors. Renal tumors are rare in the neonatal period. Although Wilms tumor is the most common renal malignancy in childhood, the neonatal period is more often marked by other neoplasms. Congenital mesoblastic nephroma is the most common renal neoplasm in neonates. Malignant rhabdoid tumor of the kidney, clear cell sarcoma of the kidney, and other rarer tumors may also be seen in this younger age group with relatively greater frequency. Although some may be detected prenatally, a greater proportion present after birth, most often with a palpable abdominal mass with or without other associated symptoms. Cross-sectional imaging is typically followed by radical nephrectomy to make a specific histologic diagnosis to determine the need for additional therapy.
Editorial team (being constituted) includes: Dr. Md. Mozibur Rahman
Last edited: April 11, 2021
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