Case 340

Newborn, male, with a history of oligohydramnios that required intrauterine vesicoamniotic shunt placement, with no success, evolving to an emergency cesarean delivery. He was delivery with a gestational age of 32 weeks and 3 days, and birth weight of 2,250 g, appropriate for gestational age. Apgar scores at 1 and 5 minutes were 5 and 7, respectively. He was intubated at the delivery room and transferred to the neonatal intensive care unit. He developed metabolic acidosis and electrolyte disturbances that were difficult to control, and progressive renal function decline [day 4: serum creatinine: 2.58 mg/dL (normal range 0.56-1.2 mg/dL) and BUN: 61 mg/dL (normal range 2-34 mg/dL), requiring peritoneal dialysis.