New dialysis machine treats infants for kidney failure at UI Stead Family Children’s Hospital

The hospital performs dialysis, a procedure to remove waste from the blood, with a new machine specially designed for infants between five and 20 pounds, making for safer treatment of kidney injuries.


Grace Kreber

University of Iowa Hospitals and Clinics is seen on Feb. 14, 2022.

Anthony Neri, News Reporter

The University of Iowa Stead Family Children’s Hospital is introducing new dialysis technology to treat infants with kidney failure.

The Cardio-Renal Pediatric Dialysis Emergency Machine, called CARPEDIEM, is specially designed to treat kidney problems in infants weighing between five and 20 pounds.

The hospital obtained two machines in May 2021 for about $35,000 each from medical device company Medtronic.

“Prior to 2020, we didn’t have anything in the United States that was designed specifically for that [treatment],” Jennifer Jetton said, clinical professor of pediatrics-nephrology at the UI Stead Family Department of Pediatrics.

The Stead Family Children’s Hospital is the fifth U.S. hospital to obtain the machine, Jetton said. The Cincinnati Children’s Hospital was the first.

Jen Ehrlich, nursing manager at the UI Hospitals and Clinics, said the procedure the machine undergoes is a prolonged type of dialysis called continuous renal replacement therapy on critically ill pediatric patients.

“Our goal is to treat the smallest of our population that have Acute Kidney Injury with this new technology,” Ehrlich said. “It helps to reduce risk in hopes that we help heal [the kidney] before it leads to permanent damage.”

The therapy helps maintain the filtering function of kidneys so swelling does not occur as a result of accumulated waste products.

“CARPEDIEM has this software, this technology to go down to the most minute precision that absolutely takes away a lot of the risk that these pediatric patients would experience if maintained on a machine made for an adult,” Ehrlich said.

Jetton said to conduct dialysis on infants before acquiring CARPEDIEM, hospital workers readjusted systems designed for adults to work on infants.

“They [machines] take blood out of the body and take it through a filter, and there’s all this tubing, so the bigger machines have bigger tubing and bigger filters, so there would be much more blood outside the body,” she said.

The Seattle Children’s Hospital also uses the machines for its tiniest patients. Shina Menon, a pediatric nephrologist at the hospital, said the large filters and tubing of the previous machines could potentially lower an infant’s blood pressure.

“Having the small machine makes it easier to provide treatment and makes it safer for them,” Menon said. “They require smaller catheters to pull blood from the baby, so that makes it accessible for the really small babies.”

Jetton said some of those filters hold three to five ounces of blood, not a concern for adults. For an infant, however, that can be thirty to forty percent of their total amount of blood.

Although both CARPEDIEM machines became available for use at Stead Family in March 2022, Medtronic provided two eight-hour training sessions for nurses and nephrologists at the hospital and has only been used once in April.

Ehrlich was present during the machine’s inaugural use at the UI.

“I was quite amazed at how smooth the entire setup and the process went and how well the patient went on when we did initiate,” she said.

The device, originally created by Claudio Ronco at San Bartolo Hospital in Italy, is becoming increasingly common in U.S. hospitals. Jetton said she’s excited for the continued use across the country to improve infant care.

“More and more centers are going to be using it, which is great,” she said. “Because the number of patients we care for is so small, we all talk to each other and depend on each other about best practices and what’s worked and what hasn’t and how to really provide the best care for these patients.”

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