{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:20:00Z","timestamp":1791566400268,"version":"4.3.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Emerging data indicate that acute kidney injury (AKI) may contribute to a worse prognosis in the infant population. Kidney replacement therapy (KRT) can be used to treat patients with AKI; however, this technique is challenging in patients in the neonatal intensive care units (NICUs) due to the low body weights and blood volumes in this population. Peritoneal dialysis (PD) is a potential modality since it is technically less challenging. However, PD has been associated with several disadvantages, including poor fluid status control, catheter-associated leakage, and peritonitis. Unfortunately, these complications can cause the temporary cessation of PD. Continuous kidney replacement therapy (CKRT) may represent a suitable alternative for PD. CKRT may be technically feasible in infants; however, little is known about the application of CKRT in neonates with low body weights. In this report, we discuss three cases of CKRT who were treated in the NICU at a tertiary medical center in southern Taiwan. We selected an adequate catheter diameter and achieved vascular access <jats:italic>via<\/jats:italic> an internal jugular vein or umbilical vein. The prescription of an appropriate dose of heparin was then used to prolong the circuit life of the CKRT. The maintenance of circuit durability in neonates with low body weight remains problematic. We hope that our experience can assist with the future clinical management of CKRT in neonates with low body weight.<\/jats:p>","DOI":"10.3389\/fped.2021.769220","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T07:19:37Z","timestamp":1637133577000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["A Case Series: Continuous Kidney Replacement Therapy in Neonates With Low Body Weight"],"prefix":"10.3389","volume":"9","author":[{"given":"Chen-Yu","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Chieh","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/S2352-4642(17)30069-X","article-title":"Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study","volume":"1","author":"Jetton","year":"2017","journal-title":"Lancet Child Adolesc Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1097\/MCC.0b013e32835a1c44","article-title":"Fluid overload in AKI: epiphenomenon or putative effect on mortality?","volume":"18","author":"Butcher","year":"2012","journal-title":"Curr Opin Crit Care."},{"key":"B3","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1177\/089686080102100410","article-title":"Peritoneal dialysis for management of pediatric acute renal failure","volume":"21","author":"Flynn","year":"2001","journal-title":"Perit Dial Int."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1928","DOI":"10.1016\/j.jfma.2021.06.021","article-title":"A central venous catheter as an alternative peritoneal dialysis tube in an extremely low birth weight infant: a practical life-saving method for medical-resource-limited institutions","volume":"120","author":"Chen","year":"2021","journal-title":"J Formos Med Assoc."},{"key":"B5","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1007\/BF01706202","article-title":"Acute renal failure in infancy: treatment by continuous renal replacement therapy","volume":"21","author":"Ronco","year":"1995","journal-title":"Intensive Care Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jss.2016.04.031","article-title":"Outcome assessment of renal replacement therapy in neonates","volume":"204","author":"Maizlin","year":"2016","journal-title":"J Surg Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3747\/pdi.2012.00293","article-title":"Impact of break-in period on the short-term outcomes of patients started on peritoneal dialysis","volume":"34","author":"Liu","year":"2014","journal-title":"Perit Dial Int."},{"key":"B8","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1016\/0967-2109(95)00125-5","article-title":"Continuous venovenous haemofiltration in neonates with renal insufficiency resulting from low cardiac output syndrome after cardiac surgery","volume":"4","author":"Leyh","year":"1996","journal-title":"Cardiovasc Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1007\/s004670100702","article-title":"Extracorporeal dialysis in neonatal hyperammonemia: modalities and prognostic indicators","volume":"16","author":"Picca","year":"2001","journal-title":"Pediatr Nephrol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1007\/s00467-010-1549-3","article-title":"Continuous hemofiltration in the control of neonatal hyperammonemia: a 10-year experience","volume":"25","author":"Westrope","year":"2010","journal-title":"Pediatr Nephrol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.jpeds.2012.08.044","article-title":"Continuous renal replacement therapy for children \u2264 10 kg: a report from the prospective pediatric continuous renal replacement therapy registry","volume":"162","author":"Askenazi","year":"2013","journal-title":"J Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.pedneo.2017.11.015","article-title":"Renal replacement therapy in the neonatal intensive care unit","volume":"59","author":"Diane Mok","year":"2018","journal-title":"Pediatr Neonatol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"984","DOI":"10.3349\/ymj.2019.60.10.984","article-title":"Continuous renal replacement therapy in preterm infants","volume":"60","author":"Noh","year":"2019","journal-title":"Yonsei Med J."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s004670050068","article-title":"Management of acute renal failure in newborns","volume":"14","author":"Gouyon","year":"2000","journal-title":"Pediatr Nephrol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1177\/039139880602901202","article-title":"Evaluation of the PRISMA M10 circuit in critically ill infants with acute kidney injury: a report from the Prospective Pediatric CRRT Registry Group","volume":"29","author":"Goldstein","year":"2006","journal-title":"Int J Artif Organs."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1177\/039139880703001212","article-title":"The effect of vascular access location and size on circuit survival in pediatric continuous renal replacement therapy: a report from the PPCRRT registry","volume":"30","author":"Hackbarth","year":"2007","journal-title":"Int J Artif Organs."},{"key":"B17","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1038\/ki.1986.85","article-title":"Treatment of acute renal failure in newborns by continuous arterio-venous hemofiltration","volume":"29","author":"Ronco","year":"1986","journal-title":"Kidney Int."},{"key":"B18","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/s00134-003-2047-x","article-title":"Citrate vs. heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study","volume":"30","author":"Monchi","year":"2004","journal-title":"Intens Care Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1053\/j.ajkd.2011.11.030","article-title":"Regional citrate versus heparin anticoagulation for continuous renal replacement therapy: a meta-analysis of randomized controlled trials","volume":"59","author":"Wu","year":"2012","journal-title":"Am J Kidney Dis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1590\/S0104-42302007000500023","article-title":"[Anticoagulation in continuous renal replacement therapies (CRRT)]","volume":"53","author":"Garc\u00e9s","year":"2007","journal-title":"Rev Assoc Med Bras (1992)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"R93","DOI":"10.1186\/cc6965","article-title":"Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study","volume":"12","author":"del Castillo","year":"2008","journal-title":"Crit Care."},{"key":"B22","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/1744-9987.12224","article-title":"Factors affecting circuit life during continuous renal replacement therapy in children with liver failure","volume":"19","author":"Goonasekera","year":"2015","journal-title":"Ther Apher Dial."},{"key":"B23","doi-asserted-by":"publisher","first-page":"R184","DOI":"10.1186\/cc8172","article-title":"Complications of continuous renal replacement therapy in critically ill children: a prospective observational evaluation study","volume":"13","author":"Santiago","year":"2009","journal-title":"Crit Care."},{"key":"B24","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3345\/kjp.2012.55.8.286","article-title":"Continuous renal replacement therapy in neonates weighing less than 3 kg","volume":"55","author":"Sohn","year":"2012","journal-title":"Korean J Pediatr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s00467-018-4047-7","article-title":"Hemodynamic impact of the connection to continuous renal replacement therapy in critically ill children","volume":"34","author":"Fern\u00e1ndez","year":"2019","journal-title":"Pediatr Nephrol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1007\/s00134-019-05707-w","article-title":"Mechanisms for hemodynamic instability related to renal replacement therapy: a narrative review","volume":"45","author":"Douvris","year":"2019","journal-title":"Intensive Care Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e189","DOI":"10.1097\/PCC.0b013e3182745675","article-title":"Pediatric Risk, Injury, Failure, Loss, End-Stage renal disease score identifies acute kidney injury and predicts mortality in critically ill children: a prospective study","volume":"14","author":"Soler","year":"2013","journal-title":"Pediatr Crit Care Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jcrc.2019.07.004","article-title":"Hypotension within one-hour from starting CRRT is associated with in-hospital mortality","volume":"54","author":"Shawwa","year":"2019","journal-title":"J Crit Care."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1016\/S0140-6736(14)60799-6","article-title":"Continuous renal replacement therapy in neonates and small infants: development and first-in-human use of a miniaturised machine (CARPEDIEM)","volume":"383","author":"Ronco","year":"2014","journal-title":"Lancet."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1007\/s00467-014-2923-3","article-title":"Haemodialysing babies weighing <8 kg with the Newcastle infant dialysis and ultrafiltration system (Nidus): comparison with peritoneal and conventional haemodialysis","volume":"29","author":"Coulthard","year":"2014","journal-title":"Pediatr Nephrol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"e195418","DOI":"10.1001\/jamanetworkopen.2019.5418","article-title":"Association of net ultrafiltration rate with mortality among critically ill adults with acute kidney injury receiving continuous venovenous hemodiafiltration: a secondary analysis of the randomized evaluation of normal vs augmented level (RENAL) of renal replacement therapy trial","volume":"2","author":"Murugan","year":"2019","journal-title":"JAMA Network Open."},{"key":"B32","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1093\/ckj\/sfz179","article-title":"Net ultrafiltration rate and its impact on mortality in patients with acute kidney injury receiving continuous renal replacement therapy","volume":"14","author":"Tehranian","year":"2021","journal-title":"Clin Kidney J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000517281","article-title":"Association between net ultrafiltration rate and renal recovery among critically ill adults with acute kidney injury receiving continuous renal replacement therapy: an observational cohort study","volume":"50","author":"Murugan","year":"2021","journal-title":"Blood Purification."},{"key":"B34","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s13054-018-2163-1","article-title":"Net ultrafiltration intensity and mortality in critically ill patients with fluid overload","volume":"22","author":"Murugan","year":"2018","journal-title":"Critical Care."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.769220\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T07:19:40Z","timestamp":1637133580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.769220\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,17]]},"references-count":34,"alternative-id":["10.3389\/fped.2021.769220"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.769220","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,17]]},"article-number":"769220"}}