Early continuous renal replacement therapy for acute kidney injury in a very low birth weight infant: a case report and literature review

The article describes a case of a neonate born at 31 weeks of gestation with a birth weight of 1,470 g who was admitted to intensive care following severe perinatal asphyxia. The infant rapidly developed acute kidney injury with persistent oliguria, metabolic acidosis, and fluid retention. Despite supportive care including mechanical ventilation and vasoactive support, the patient's condition deteriorated. Continuous renal replacement therapy in hemodiafiltration mode was initiated approximately 20 hours after birth. After 37 hours of treatment, urine output increased from 0.11 to 3.9 mL/(kg·h), serum creatinine decreased from 118.20 to 55.20 μmol/L, and blood urea nitrogen decreased from 12.27 to 5.26 mmol/L. The infant was subsequently weaned from therapy and mechanical ventilation and was discharged in stable condition. The results suggest that early and graduated renal replacement therapy may contribute to maintaining hemodynamic stability and facilitating organ function recovery.