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Doctors make mini dialysis machine for tiny babies to avoid problems of adult-sized machines

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LONDON - Doctors in Italy have designed a miniature dialysis machine for babies, used for the first time last year to save a newborn girl, according to a new report.

Usually, doctors adapt standard dialysis machines for babies, but that can be risky since the devices can't always be accurately tweaked. About 1 to 2 per cent of hospitalized infants have kidney problems that may require dialysis, which cleans toxins from the blood when the kidneys aren't working.

"Only a small number of (babies) need this treatment, but it could be life-saving," said Dr. Heather Lambert, a pediatric kidney specialist and spokeswoman for Britain's Royal College of Paediatrics and Child Health.

Lambert and colleagues at the Great North Children's Hospital in Newcastle are working on a similar small dialysis device and other scientists have experimented with prototypes.

The new mini-dialysis machine, meant for babies under 10 kilograms (22 pounds), was conceived by Dr. Claudio Ronco of the San Bortolo Hospital in Vicenza, Italy and colleagues. Just weeks after the machine was licensed last summer by European authorities, they got their first patient: a 3-day-old baby girl weighing about 3 kilograms (6.6 pounds) with multiple organ failure.

"Her parents had already reserved the funeral," Ronco said. Instead, the baby was treated for nearly a month. She and her parents recently paid Ronco a visit.

"The baby was crying like crazy because she was hungry, but she's doing great," Ronco said. The baby has mild kidney problems and needs vitamin D supplements but is otherwise growing normally, he said.

Since then, about 10 other babies have been treated with the machine across Europe.

The development of the dialysis machine and its first patient were described in a paper published online Thursday in the journal Lancet. The research was paid for by an Italian kidney advocacy group. The dialysis machines cost 35,000 euros ($47,801) and Ronco does not profit from their sales.

"This is a pretty major advance for the smallest infants," said Dr. Bethany Foster, an associate professor of pediatrics at the Montreal Children's Hospital in Canada, who co-authored an accompanying commentary. "I can't imagine the baby they (treated) would have survived with the current technology."

Foster emphasized that doctors should be cautious in deciding which babies to treat.

"You have to be especially vigilant with very small babies because what you're often doing amounts to heroic treatment," Foster said. "We need to be careful that we don't just do things because we can."

___

Online:

www.lancet.com

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