ArticlePediatric nephrology (Berlin, Germany)2025
Growth in neonates with congenital kidney failure requiring continuous kidney replacement therapy.
Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Neonatal continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026Review
- Nutrition delivery in infants with kidney failure on extracorporeal kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026Article
- Beyond prescriptions: why fluid bias, survivorship, and modality shifts undermine neonatal CKRT nutrition guidelines.Pediatric nephrology (Berlin, Germany) · 2026Article
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5 authors.
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Abstract
backgroundWith advanced technology, survival of neonates with congenital kidney failure (CKF) requiring continuous kidney replacement therapy (CKRT) has improved. Nutrition is essential but difficult to attain as CKRT removes proteins and micronutrients, and many patients have multiple co-morbidities. Scant data exist to guide clinicians on appropriate energy requirements for growth.
methodsWe performed a retrospective study of neonates with CKF admitted to Children's of Alabama between 2016 and 2022 who required KRT within 10 days. We evaluated risk factors and growth in the 18/24 (75%) infants who survived to 90 days. Our primary and secondary outcomes were length z-score ≥ - 2 vs. < - 2 at 90 days and weight z-score ≥ - 2 vs. < - 2 at 90 days, respectively. Demographics, comorbidities, CKRT Dose Eras (1-body surface area (2000/1.73/m
resultsAt 90 days, 7/18 (38.9%) had length z-score ≥ - 2 while 10/18 (55.6%) had a weight z-score ≥ - 2. Factors for weight z-score ≥ - 2 include time to PD transition and CKRT Dose Era 2. Factors for length z-score ≥ - 2 included Era with higher calorie and protein goal targets (both p < 0.01).
conclusionsMalnutrition in neonates with CKF on CKRT is high. More studies are needed to better understand optimal strategies to ensure adequate growth. Until then, we recommend 24 ml/kg/hr clearance dose and prescribing at least 130 kcal/kg/day and 4 g/kg/day amino acids to target higher actual intake to start for these patients.
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