A neonate with severe oligo-anuric renal failure during multi-organ failure survived with prolonged renal replacement therapy

摘要

Here, we report a neonate with severe oligo-anuric renal failure during multi-organ failure who survived with prolonged renal replacement therapy.A female neonate, born at a gestational age of 39 weeks and 3 days, weighing 2780 gram, presented cyanosis on Day 15. She developed anuria and respiratory arrest, requiring mechanical ventilation. Blood pressure was 39/24 mmHg. She was diagnosed as having interrupted aortic arch, requiring surgery (Figure 1). Serum creatinine increased from 0.34 to 1.26 mg/dL. Continuous-flow peritoneal dialysis (PD), using two catheters for dialysate infusion and drainage simultaneously, was started. She had septicemia, which was controlled with antibiotics. After surgery, chylous effusion occurred in the thorax, resulting in pleural effusion and edema. At ~2 months, she passed small volumes of urine output with renal and dia-lytic clearances of 0.98 and 11.45 rnL/min/1.73 m2, respectively. Ligation of the thoracic duct was performed at 2.5 months. Overfiuid status continued till 3 months, requiring PD and mechanical ventilation.