Fetal management of advanced chronic kidney disease

Pediatric Surgery
Dr. Foong-Yen Lim introduces the session topics of discussion, the challenges of neonatal dialysis, the pathway of renal transplantation, and pulmonary survivor qualifications. Dr. Paul Kingma, Neonatal Director, Cincinnati Fetal Center, discusses the pulmonary survivor odds based upon amniotic fluid status and postnatal factors. Dr. Jens W. Goebel discusses managing chronic kidney disease. Dr. Goebel presents a case of a fetus who had undergone interventions of vesicoamniotic shunts and amnioinfusions elsewhere and delivered at 35 weeks. The baby was born with poor initial pulmonary and renal status. The baby received urgent valve ablation and bilateral ureteral stunting after birth and began to improve and urinate. Dr. Goebel discusses lower urinary tract management, infant chronic kidney disease therapy, adult chronic kidney disease management, infant dialysis, peritoneal dialysis, and transplants. A discussion among the panel followed Dr. Goebel's presentation. Discussion topics include chronic ventilation, peritonitis development, aquafloresis, dialysis catheter, and nutrition.

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