Comparison of peritoneal dialysis versus continuous renal replacement therapy in the treatment of acute kidney injury in infants with congenital heart disease after surgery

Objective To compare the efficacies of continuous peritoneal dialysis versus continuous renal replacement therapy for acute kidney injury in infants with congenital heart disease(CHD) after surgery. Methods Retrospective analyses were performed for a total of 95 CHD infants aged under 3 years with acute renal insufficiency after operation from January 2012 to December 2013. And 52 patients received peritoneal dialysis while another 43 continuous blood purification treatment. The time until a negative balance of liquid intake and output, lactic acid recovery time, mechanical ventilation time, intensive care unit(ICU) stay length, postoperative hospitalization time and mortality were compared for two groups after operation. Results Gender, age, weight, disease, blocking time and cardiopulmonary bypass time showed no inter-group differences. The time until a negative balance of liquid intake and output in peritoneal dialysis group was 22.3±4.2 h versus 14.2±3.6 h in blood purification therapy group(P<0.01). The lactic acid recovery in peritoneal dialysis and blood purification therapy group were 10.3±5.2 and 6.8±3.4h respectively(P<0.05). The postoperative mechanical ventilation time in peritoneal dialysis group was significantly longer than that in blood purification therapy group(22.1±5.3 vs 15.6±4.2h, P<0.01). The time of renal replacement therapy in peritoneal dialysis group was statistically longer than that in blood purification group(85.4±11.7 vs 68.9±12.4h, P<0.05). ICU stay length after operation in peritoneal dialysis group was longer than blood purification therapy group(8.2±3.6 vs 5.8±2.1 days, P<0.05). Significant difference existed in postoperative hospitalization time between dialysis and blood purification groups(16.2±4.4 vs 15.2±3.2 days). Conclusions The efficacy of continuous blood purification treatment is better than peritoneal dialysis in CHD infants with acute renal insufficiency after operation. Key words: Acute kidney injury; Heart disease; Peritoneal dialysis