An inspiring success story from Dr. Rojas in Estelí, Nicaragua: following the SYL training in Bolivia, she successfully performed her first dialysis catheter placement using a central venous (CV) line—the equipment she had available. Even more remarkably, she was teaching the pediatric surgeon throughout the procedure. A wonderful example of resourcefulness, knowledge transfer, and the lasting impact of the SYL program.
This patient is a full-term baby of 39 weeks gestation weighing 3000 grams, who was reported to me on June 14th at 13 days old, referred from a very remote area of the country, with a diagnosis of complex congenital heart disease (total intracardiac anomalous pulmonary venous connection) whose diagnosis was made postnatally when presenting data of pulmonary hypertension treated in the hospital during her first 7 days with carvedilol, furosemide and spironolactone.
At 3 days old, tests revealed a creatinine level of 3 mg/dL, and at 12 days old, creatinine was 8 mg/dL and urea was 250 mg/dL, and anuria. Hence, meeting the criteria for renal replacement therapy.
Therefore, the case was transferred to my health unit in Estelí. A central venous catheter (CVC) was placed for hemodialysis since we did not have a neonatal Tenckhoff catheter.
Dialysis was performed for 14 days, resulting in improved electrolytes, acid base and blood urea nitrogen (BUN) levels, restoration of urine output, and full recovery of renal function.
The baby is currently undergoing nutritional recovery, and the mother is receiving training on the underlying treatment for the heart condition while awaiting cardiac surgery.
This is the first neonatal peritoneal dialysis performed in the unit, and thanks to the neonatology and surgery teams, Dr. Guillermo Hidalgo, and the knowledge acquired in the SYL program, we gained valuable experience and saved the life of a critically ill baby.
Thank you very much for your support.
I’m sharing a photo of the wonderful results.
Itzachelt Rojas, participant of IPNA SYL Workshop in Bolivia May 2026
