Sanderson et al reported factors predictive of mortality of an infant being dialyzed in the neonatal intensive care unit (NICU). These can help to identify an infant who may require more aggressive management. The authors are from multiple institutions in the United States.
Patient selection: neonate in NICU requiring dialysis
Mortality rate before discharge from NICU: 26%
Predictors of mortality:
(1) gestational age < 32 weeks
(2) Black race
(3) absence of kidney anomalies
(4) necrotizing enterocolitis
(5) dialysis initiated <= 7 days after birth (first week of life)
(6) receipt of paralytics
(7) receipt of vasopressors
The risk of mortality increases with the number of predictors present. The predictors are associated with greater illness severity when dialysis is started and indicators of multi-organ failure.
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