We present a case series of neonates with anuric ESRD undergoing renal replacement therapy (RRT) and discuss the associated ethical implications of RRT in this population.
We reviewed patients who initiated RRT within 1 week of life due to anuric ESRD from 2009–2019 at a single tertiary center. Primary outcomes were receipt of renal transplant (RT), one-year survival, and overall survival.
Five patients met the inclusion criteria. Two patients received an RT. One-year survival was 80%, while overall survival was 60% with a median follow-up of 18 months. In the 2 still-living patients who have not undergone RT, they are ineligible, one due to recent malignancy and the other from acquired cardiovascular comorbidities.
Patients with anuric ESRD requiring RRT undergo multiple treatment challenges with low RT and survival rates. These findings should be shared with families considering intervention for cases of severe renal disease diagnosed prenatally.
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Data is not publicly available due to patient privacy laws but are available from the corresponding author on reasonable request.
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Statement of Ethics
Our study complied with the guidelines for human studies and was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. The study protocol was approved by our institutional review board (IRB) committee on human research, approval 19–1369. This study was granted exemption from requiring written informed consent by the University of Colorado, Anschutz IRB committee.
The authors declare no competing interests.
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Han, D.S., Bock, M.E., Glover, J.J. et al. Outcomes of dialysis in neonates with anuric end-stage renal disease at birth: ethical considerations. J Perinatol 42, 920–924 (2022). https://doi.org/10.1038/s41372-022-01328-2