Catheter diameter and infection control are important in neonatal continuous kidney replacement therapy: a single-center retrospective study

Abstract Background Neonates have smaller bodies than children; reports on circuit lifetime in neonates remain scarce, even though the mortality rate is high with continuous kidney replacement therapy (CKRT). In this study, we determined the circuit lifetime of CKRT in neonates and examined the associated factors. Methods We retrospectively identified patients who were admitted to our neonatal intensive care unit and underwent CKRT from 1 January 2014 to 31 December 2022. A survival analysis of circuit lifetime was performed, and the Cox proportional hazards model was developed to analyze the impact on circuit occlusion. Results In total, 88 circuits were assembled, with 69 occluded and 19 detached circuits. The median corrected age at CKRT therapy was 39.6 (interquartile range [IQR] 35.4–42.3) weeks, weight was 2508 (1500–3090) g, catheter diameter was 1.2 (0.8–1.8) mm, and circuit lifetime was 16.0 (7.5–38.1) h. The hazard ratio for circuit lifetime was 1.04 (95% confidence interval [CI] 0.97–1.11), 1.00 (1.00–1.00), 0.62 (0.40–0.96), and 0.41 (0.21–0.80) for corrected age, weight, catheter diameter, and bacteremia, respectively. Conclusions Appropriate selection of catheter and infection management are important for safe CKRT.