Dialysis in the neonatal period. A life-saving therapy with good long-term outcome

Background. There are several indications for dialysis therapy in neonates. Until now only few studies have evaluated the long-term outcome of these children. Study design. In all, 43 neonates were dialysed between 1992 and 2012 at the University Children's Hospital, Heidelberg: 20 had kidney disease, 18 suffered from hyperammonemia, and 5 had an acute kidney failure or multiorgan failure due to other systemic diseases. The organic and psychomotor developments of these patients have been retrospectively examined in this study. Results. Detoxification and dehydration therapy were effective in all cases. None of our patients died of dialysis-related complications. The survival rate was high (84%) in all groups. The psychomotor development was normal or mildly retarded in patients with kidney disease, whereas patients with underlying metabolic illness showed severe deficits (50%). Conclusion. Neonates with acute renal insufficiency or hyperammonemia should be immediately treated in perinatal centers with a dialysis facility since prompt treatment is crucial for survival and long-term outcome.