Peritoneal dialysis: An effective therapeutic modality in acute kidney injury

Med J Armed Forces India. 2023 Jul-Aug;79(4):458-463. doi: 10.1016/j.mjafi.2020.09.003. Epub 2020 Nov 26.

Abstract

Background: Peritoneal dialysis (PD) as a modality of renal replacement therapy (RRT) in acute kidney injury (AKI), continues to be underused. We present our experience with PD in patients with AKI.

Method: The data of patients with AKI requiring RRT were retrospectively analyzed. The primary end point was the adequacy of dialysis, and the secondary end point included hemodynamic stability and procedure-related complications.

Result: A total of 32 patients with AKI requiring RRT were included in the study. The mean age and the blood pressure at the time of hospitalization were 65.3 ± 6.73 years and 73.7 ± 8.4 mm Hg, respectively. All the patients required vasopressor support; 26 (81%) patients required ventilator support. RRT was initiated at a mean serum creatinine of 6.24 ± 1.17 mg/dL. Rigid stylet catheter was used in 9 (28.2%) and Tenckhoff catheter in 23 (71.8%) patients. The average daily ultrafiltration and weekly Kt/V achieved were 1701 ± 327 mL and 2.19, respectively; these were significantly higher in survivors. After the initiation of PD, hemodynamic instability was observed in 10 (31.2%) patients. The major therapy-related complication noted was PD peritonitis.

Conclusions: In a resource-poor environment, PD is an effective modality of RRT for AKI.

Keywords: Acute kidney injury; Dialysis dose; Peritoneal dialysis.