Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;38(3):867-876.
doi: 10.1007/s00467-022-05575-5. Epub 2022 Jul 5.

Kidney replacement therapy in neonates: utilization trends and outcomes

Marwa M Elgendy  1 , Hasan F Othman  2 , Mohamed A Mohamed  3 , Raed Bou Matar  4 , Hany Aly  3
Affiliations

Kidney replacement therapy in neonates: utilization trends and outcomes

Marwa M Elgendy et al. Pediatr Nephrol. 2023 Mar.

Abstract

Background: We aimed to assess prevalence and clinical characteristics of newborns receiving kidney replacement therapy (KRT).

Methods: We used the National Inpatient Sample (NIS) dataset for the years 2000-2017. Newborns treated with peritoneal dialysis (PD), hemodialysis (HD), and continuous KRT (CKRT) were included. Trend analysis using the Cochran-Armitage test was used to assess prevalence over the years.

Results: A total of 64,532,552 hospitalized newborns were included. Among the 4281 infants treated with KRT, 2501 (58.4%) were treated with PD, 997 (23.3%) had HD, and 783 (18.3%) used CKRT. Associated diagnoses included congenital kidney anomalies (37.4% vs. 15% vs. 9.5%), urinary tract anomalies (35% vs. 12.5% vs. 6.3%), and congenital heart disease (68% vs. 25.7% vs. 72.3%). Median length of stay was longest in PD patients (39 days vs. 18 days vs. 26 days), respectively. However, cost of hospitalization was greatest in CKRT patients (US $490,916 vs. US $218,514 vs. US $621,554), respectively. In the entire cohort, 54,424 newborns had acute kidney injury (AKI); of them 16,999 (31%) died. KRT was used in 2,688 (4.9%) of infants with AKI. Over the study period, trends for utilization of PD (from 0.042 to 0.06%) and CKRT (from 0.03 to 0.21%) increased whereas the hemodialysis trend decreased (from 0.021 to 0.013%).

Conclusions: Congenital heart disease (CHD) and congenital anomalies of the kidneys and urinary tract (CAKUT) are the major diagnoses in newborns receiving KRT. Utilization of PD was greater than HD and CKRT. Trends of PD and CKRT utilization increased over time. Less than 5% of infants diagnosed with AKI received KRT.

Keywords: AKI; Dialysis; Full-term infants; Mortality; Prevalence; VLBW infants.

PubMed Disclaimer

References

    1. Hakan N, Aydin M, Zenciroglu A, Aydog O, Erdogan D, Karagol BS, Dursun A, Okumus N (2014) Acute peritoneal dialysis in the newborn period: a 7-year single-center experience at tertiary neonatal intensive care unit in Turkey. Am J Perinatol 31:335–338
    1. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, Chishti AS, Woroniecki R, Mammen C, Swanson JR, Sridhar S, Wong CS, Kupferman JC, Griffin RL, Askenazi DJ, Neonatal Kidney Collaborative (NKC) (2017) Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicenter, multinational, observational cohort study. Lancet Child Adolesc Health 1:184–194 - DOI
    1. Jetton JG, Askenazi DJ (2012) Update on acute kidney injury in the neonate. Curr Opin Pediatr 24:191–196 - DOI
    1. Charlton JR, Boohaker L, Askenazi D, Brophy PD, Fuloria M, Gien J, Griffin R, Hingorani S, Ingraham S, Mian A, Ohls RK, Rastogi S, Rhee CJ, Revenis M, Sarkar S, Starr M, Kent AL (2019) Late onset neonatal acute kidney injury: results from the AWAKEN Study. Pediatr Res 85:339–348
    1. Elgendy MM, Othman HF, Younis M, Puthuraya S, Bou Matar R, Aly H (2021) Trends and racial disparities for acute kidney injury in premature infants: the US national database. Pediatr Nephrol 36:2789–2795 - DOI