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El Nov 29, 2003 10:51 am, Text-conference November 26 dijo:
[22:14] (MJesus> are you ready Dr. Balasubramanian ?
[22:14] (balas> Yes
[22:14] (|> Neonatal Renal Failure
[22:14] (|> J. Balasubramaniam
[22:15] (|> Kidney Care centre. Tirunelveli, Tamilnadu. India
[22:15] (|> Renal failure in neonate is a vexing problem for more than one
reason.
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[22:25] (|> ________ resume is over________
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[22:26] (gtorres> is there any question
[22:26] (Columbia> very good
[22:26] (balas> Thank you for the oppurtunity
[22:26] (Cornelius> asombroso!
[22:27] (gtorres> congratulations Dr. Balas. Your paper are very good. I am nephrologist of adults. Sometimes I have had to make peritoneal dialysis a neonate and I have suffered much. I hope that with the dialysis guidelines that you indicate to us we make the next time better
[22:28] (balas> truth is that i am also an adult nephrologist
[22:28] (balas> but in my centre i have been made to take care of neonates and here i am
[22:28] (carvan> what parameters to decide for conservative or substitutive therapy?
[22:30] (balas> one should go by clinical setting rather than creat level
[22:30] (balas> the capacity to recover is great in neonates
[22:30] (balas> pd is not difficult as we think in neonates
[22:30] (carvan> how long should i wait for the anuria to solve before starting a substitutive treatment?
[22:32] (balas> but in my series only 4 out of 37 required dialysis
[22:32] (balas> anuria for more than 24 hrs is better taken up
[22:32] (balas> but many improve before that
[22:32] (pedro> how many cc do you advice we can put inside the abdomen of the neonates?
[22:32] (balas> 20 - 30 ml/kg
[22:32] (gtorres> is there specialyste in neonatology in your hospital?
[22:33] (balas> in case of resp distress go for the lower volume
[22:33] (Alina> have a question for you dr balas.!
[22:33] (Alina> do you prefer... peritoneal dialysis or hemodyalisis ?
[22:34] (balas> yes. it is easier with neonatologists around
[22:34] (balas> definitely pd
[22:34] (balas> hd is is not pracicable in most centres
[22:34] (balas> i use the regular pediatric caths for the neonates also
[22:35] (Rosa> why not use both!? or try to use...
[22:35] (balas> sometimes you may have trim down the tip
[22:35] (balas> and one session of pd can get many neonates out of trouble if the underlying cause is reversible
[22:35] (gtorres> another any question?
[22:36] (balas> in our centre we see lot of arf following asphyxia, neonatal sepsis which are often recoverable
[22:37] (balas> have you tried aminophylline
[22:38] (balas> it can be used for any incipient arf
[22:38] (balas> even in adults
[22:38] (MJesus> more question or commentary ?
[22:39] (balas> my message is to encourage all nephrologists to take up neonates also
[22:39] (balas> it is worth the trouble
[22:39] (balas> if irreversible cause is noted then ofcourse
[22:41] (balas> it is better to leave the neonate alone
[22:42] (balas> I hope there is good discussion for the doppler papper
[22:42] (MJesus> if you are ready, we start the discussion of next paper from you also
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