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Cholerzyńska H, Zasada W, Michalak H, Miedziaszczyk M, Oko A, Idasiak-Piechocka I. Urgent Implantation of Peritoneal Dialysis Catheter in Chronic Kidney Disease and Acute Kidney Injury-A Review. J Clin Med 2023; 12:5079. [PMID: 37568481 PMCID: PMC10419992 DOI: 10.3390/jcm12155079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/13/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Acute kidney injury (AKI) and sudden exacerbation of chronic kidney disease (CKD) frequently necessitate urgent kidney replacement therapy (UKRT). Peritoneal dialysis (PD) is recognized as a viable modality for managing such patients. Urgent-start peritoneal dialysis (USPD) may be associated with an increased number of complications and is rarely utilized. This review examines recent literature investigating the clinical outcomes of USPD in CKD and AKI. Relevant research was identified through searches of the MEDLINE (PubMed), Scopus, Web of Science, and Google Scholar databases using MeSH terms and relevant keywords. Included studies focused on the emergency use of peritoneal dialysis in CKD or AKI and reported treatment outcomes. While no official recommendations exist for catheter implantation in USPD, the impact of the technique itself on outcomes was found to be less significant compared with the post-implantation factors. USPD represents a safe and effective treatment modality for AKI, although complications such as catheter malfunctions, leakage, and peritonitis were observed. Furthermore, USPD demonstrated efficacy in managing CKD, although it was associated with a higher incidence of complications compared to conventional-start peritoneal dialysis. Despite its cost-effectiveness, PD requires greater technical expertise from medical professionals. Close supervision and pre-planning for catheter insertion are essential for CKD patients. Whenever feasible, an urgent start should be avoided. Nevertheless, in emergency scenarios, USPD does remain a safe and efficient approach.
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Affiliation(s)
| | | | | | - Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (H.C.); (W.Z.); (H.M.); (A.O.); (I.I.-P.)
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Liu K, Koyner JL, Heung M, Vijayan A. Care of the Hospitalized Patients with Kidney Failure during COVID-19 Pandemic: Lessons Learned. Clin J Am Soc Nephrol 2023; 18:01277230-990000000-00058. [PMID: 36795034 PMCID: PMC10356130 DOI: 10.2215/cjn.0000000000000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Kathleen Liu
- Divisions of Nephrology and Critical Care Medicine, Departments of Medicine and Anesthesia, University of California at San Francisco, San Francisco, California
| | - Jay L. Koyner
- Section of Nephrology, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Michael Heung
- Division of Nephrology, University of Michigan, Ann Arbor, Michigan
| | - Anitha Vijayan
- Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri
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Sourial MY, Gone A, Uribarri J, Srivatana V, Sharma S, Shimonov D, Chang M, Mowrey W, Dalsan R, Sedaliu K, Jain S, Ross MJ, Caplin N, Chen W. Outcomes of PD for AKI treatment during COVID-19 in New York City: A multicenter study. Perit Dial Int 2023; 43:13-22. [PMID: 36320182 PMCID: PMC10115518 DOI: 10.1177/08968608221130559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The high incidence of acute kidney injury (AKI) requiring dialysis associated with COVID-19 led to the use of peritoneal dialysis (PD) for the treatment of AKI. This study aims to compare in-hospital all-cause mortality and kidney recovery between patients with AKI who received acute PD versus extracorporeal dialysis (intermittent haemodialysis and continuous kidney replacement therapy). METHODS In a retrospective observational study of 259 patients with AKI requiring dialysis during the COVID-19 surge during Spring 2020 in New York City, we compared 30-day all-cause mortality and kidney recovery between 93 patients who received acute PD at any time point and 166 patients who only received extracorporeal dialysis. Kaplan-Meier curves, log-rank test and Cox regression were used to compare survival and logistic regression was used to compare kidney recovery. RESULTS The mean age was 61 ± 11 years; 31% were women; 96% had confirmed COVID-19 with median follow-up of 21 days. After adjusting for demographics, comorbidities, oxygenation and laboratory values prior to starting dialysis, the use of PD was associated with a lower mortality rate compared to extracorporeal dialysis with a hazard ratio of 0.48 (95% confidence interval: 0.27-0.82, p = 0.008). At discharge or on day 30 of hospitalisation, there was no association between dialysis modality and kidney recovery (p = 0.48). CONCLUSIONS The use of PD for the treatment of AKI was not associated with worse clinical outcomes when compared to extracorporeal dialysis during the height of the COVID-19 pandemic in New York City. Given the inherent selection biases and residual confounding in our observational study, research with a larger cohort of patients in a more controlled setting is needed to confirm our findings.
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Affiliation(s)
- Maryanne Y Sourial
- Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Anirudh Gone
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Jaime Uribarri
- Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vesh Srivatana
- Division of Nephrology and Hypertension, Weill Cornell Medicine, New York, New York, USA
- The Rogosin Institute, New York, NY, USA
| | - Shuchita Sharma
- Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniil Shimonov
- Division of Nephrology and Hypertension, Weill Cornell Medicine, New York, New York, USA
- The Rogosin Institute, New York, NY, USA
| | - Michael Chang
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Wenzhu Mowrey
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rochelle Dalsan
- Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kaltrina Sedaliu
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Swati Jain
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Michael J Ross
- Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
| | - Nina Caplin
- Division of Nephrology, New York University Langone Health and New York University Grossman School of Medicine, New York, NY, USA
- Department of Medicine, New York City Health and Hospitals/Bellevue, New York, NY, USA
| | - Wei Chen
- Division of Nephrology, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Montefiore Medical Center, Bronx, NY, USA
- Division of Nephrology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Cullis B. Peritoneal dialysis for acute kidney injury: back on the front-line. Clin Kidney J 2022; 16:210-217. [PMID: 36755845 PMCID: PMC9900590 DOI: 10.1093/ckj/sfac201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Indexed: 11/12/2022] Open
Abstract
Peritoneal dialysis (PD) for acute kidney injury (AKI) has been available for nearly 80 years and has been through periods of use and disuse largely determined by availability of other modalities of kidney replacement therapy and the relative enthusiasm of clinicians. In the past 10 years there has been a resurgence in the use of acute PD globally, facilitated by promotion of PD for AKI in lower resource countries by nephrology organizations effected through the Saving Young Lives program and collaborations with the World Health Organisation, the development of guidelines standardizing prescribing practices and finally the COVID-19 pandemic. This review highlights the history of PD for AKI and looks at misconceptions about efficacy as well as the available evidence demonstrating that acute PD is a safe and lifesaving therapy with comparable outcomes to other modalities of treatment.
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Atlani MK, Pilania RK, Bhatt GC. Outcomes following peritoneal dialysis for COVID-19-induced AKI: A literature review. Perit Dial Int 2022; 42:554-561. [PMID: 35938619 DOI: 10.1177/08968608221115000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Acute kidney injury (AKI) has been shown to be associated with significant morbidity and mortality in patients with severe COVID-19 disease. Due to increasing number of cases in pandemic, there is a significant shortage of medical facilities and equipment in relation to patient load. In low resource settings where access to intermittent haemodialysis (HD) or continuous kidney replacement therapy (CKRT) is limited, peritoneal dialysis (PD) may play a vital role in the management of COVID-19-induced AKI. A literature search using Medline/PubMed, Embase, Google Scholar and Cochrane register was performed using following search strategy: (((COVID 19) OR (SARS-CoV-2)) AND (((acute kidney injury) OR (acute renal failure)) OR (acute renal dysfunction))) AND (peritoneal dialysis). Search strategy yielded total 79 articles. After going through titles and abstracts, full text of 15 articles was obtained. Finally, six studies were included in the review after exclusion of 10 studies. Five studies were single centre and one study was multicentric; four studies were conducted in the United States and one in the United Kingdom; PD catheter placement was done by surgeons in three studies and by nephrologist in one study. The mortality reported in the studies varied from 43% to as high as 63%.
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Affiliation(s)
| | - Rakesh Kumar Pilania
- Pediatric Allergy Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Sciences (PGIMER), Chandigarh
| | - Girish Chandra Bhatt
- Department of Pediatrics, ISN-SRC, All India Institute of Medical Sciences (AIIMS), Bhopal
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Couchoud C, Verger C. Symptomatic SARS-CoV2 infections in patients treated in France by hemodialysis in an establishment, or at home or by peritoneal dialysis: Data from the REIN and RDPLF registries. BULLETIN DE LA DIALYSE À DOMICILE 2020. [DOI: 10.25796/bdd.v3i4.59643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In France all patients treated with dialysis are registered in the REIN registry (Epidemiology and Information Network in Nephrology) ; in addition the RDPLF (French Language Peritoneal Dialysis Registry) monitors patients treated at home in French-speaking regions and countries.
Asymptomatic patients with a positive SARS-CoV2 test were excluded : the study focused only on patients with symptomatic COVID-19 disease. Data from REIN and RDPLF were used. In total, 3,541 patients were declared symptomatic with COVID-19. The proportion of patients with symptomatic SAR-coV2 infection was 4.9% in patients treated at home by peritoneal dialysis or hemodialysis and 8.0% in those treated in a dialysis unit. After adjustment for age and comorbidities, being treated at home was associated with a higher risk of mortality. In conclusion, home treatments could represent a solution for preventing the risk of contamination during the circulation of the virus. On the other hand, the risk of mortality in symptomatic patients at home could be linked to a delay in treatment: rigorous remote organization must be implemented so as not to delay the treatment of patients in the event of infection.
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