Pediatrics World Conference 2026

Abstract

According to various studies, the incidence of acute kidney injury (AKI) in neonate ranges from 22% to 30% of neonatal intensive care unit (NICU) patients. The need for renal replacement therapy ranges from 1% to 9%, depending on the patient group. To provide dialysis and other extracorporeal treatments, a specialized dialysis center for newborns and premature infants has been opened in Moscow.

Since 2019, 837 patients have received treatment at the Neonatal Nephrology and Dialysis Center, 341 of whom were treated with dialysis, therapeutic plasma exchange (TPE), or hemoperfusion. 45% of patients were full-term, the remainder were premature with varying gestational ages starting from 23 weeks and 2 days. The group of patients with AKI included 301 infants, congenital renal failure and chronic kidney disease were present in 35, and hyperammonemia without AKI was present in 5. The main causes of AKI were: early and late neonatal sepsis (n=101, 29.6%), previous asphyxia (n=35, 10.3%), various surgical pathologies and 6 patients were on extracorporeal membrane oxygenation.

Indications for dialysis were standard: fluid overload greater than 15% combined with oliguria or anuria and/or hyperkalemia and/or metabolic acidosis, ammonia levels above 500 μmol/L. Indications for hemoperfusion were septic shock or proven rhabdomyolysis, and for therapeutic plasma exchange (TPE) – hyperbilirubinemia. Peritoneal dialysis in various modifications was used in 239 newborns, continuous veno-venous hemodiafiltration/hemodialysis/hemofiltration – in 24, and a combination of various techniques in 76 children, including hemoperfusion in 39, isolated hemoperfusion in 2, and TPE in 3. The smallest patient receiving peritoneal dialysis weighed 470 g, while the smallest patient receiving CVVHDF and hemoperfusion weighed 780 g. Mortality among full-term infants receiving dialysis was 33%, while among preterm infants, it was 55.1%.

Conclusion: The use of dialysis and other extracorporeal technologies in neonatology can reduce mortality even in critically ill patients, and the creation of specialized centers facilitates the accumulation of clinical experience and advances technological development.

Studied at the Russian State Medical University from 1997 to 2003, completed residency in anesthesiology and resuscitation in 2003-2005, worked as a resuscitator in the dialysis department from 2005 to 2019, and has been the head of the neonatal nephrology and dialysis center since 2019. PhD in medicine since 2011.