Abstract: Objective  To investigate the efficacy and safety of continuous renal replacement therapy(CRRT) in neonates with acute kidney injury(AKI).  Method  The AKI neonates treated with CRRT and admitted to our department from January 2015 to October 2021 were enrolled. Serum creatinine(Scr), blood urea nitrogen(BUN), urine output and the use of vasoactive drugs were analyzed at the three time points (before treatment, after 12-24 hours and at the end of the treatment). The complications and prognosis were also observed. Result A total of 12 neonates were involved, including 9 males and 3 females with gestational age of (36.6±3.0) weeks and birth weight of (2765.4±697.6)g. The primary diseases included birth asphyxia (7 cases), pneumonia (one case), congenital omphalocele (one case), congenital jejunal atresia (one case), neonatal septicemia (one case) and meconium aspiration syndrome (one case). Their median age was 3 (1, 4.8) days, and the operation time was (73.5±59.5) h. Finally, 4 patients survived, one patient was given up, and 7 patients died. There was no significant difference in age between cured neonates and those who died or were given up (Z=-0.352, P=0.725). The complications included electrolyte imbalance (8 cases), thrombocytopenia (5 cases) and tube blockage (3 cases). Compared with those before CRRT, BUN was significantly decreased 12～24h after CRRT (Z=-2.118, P=0.034), BUN showed a downward trend at the end of treatment, but the difference was not statistically significant (Z=-1.257, P=0.232); Scr levels were significantly decreased (t=4.528,  P=0.001; t=3.372, P=0.006) and the urine output was significantly increased (Z=-2.670, P=0.008; Z=-2.937, P=0.003) after 12～24 hours of CRRT and at the end of CRRT. Eleven neonates were treated with vasoactive drugs before CRRT; after 12～24 hours of CRRT, one patient stopped using vasoactive drugs and 6 patients reduced the dosage; at the end of CRRT, 5 patients stopped using vasoactive drugs, and 3 patients reduced the dosage.  Conclusion  The application of CRRT in neonates with AKI is effective and safe, and the complications was controllable.

Key words: Continuous renal replacement therapy, Acute kidney injury, Neonate, Effectiveness, Safety