High-volume peritoneal dialysis in acute kidney injury: indications and limitations.

نویسندگان

  • Daniela Ponce
  • Marina Nogueira Berbel
  • Cassiana Regina de Goes
  • Cibele Taís Puato Almeida
  • André Luís Balbi
چکیده

BACKGROUND AND OBJECTIVES Peritoneal dialysis is still used for AKI in developing countries despite concerns about its limitations. The objective of this study was to explore the role of high-volume peritoneal dialysis in AKI patients in relation to metabolic and fluid control, outcome, and risk factors associated with death. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A prospective study was performed on 204 AKI patients who were assigned to high-volume peritoneal dialysis (prescribed Kt/V=0.60/session) by flexible catheter and cycler; 150 patients (80.2%) were included in the final analysis. RESULTS Mean age was 63.8±15.8 years, 70% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (54.7%). BUN and creatinine levels stabilized after four sessions at around 50 and 4 mg/dl, respectively. Fluid removal and nitrogen balance increased progressively and stabilized around 1200 ml and -1 g/d after four sessions, respectively. Weekly delivered Kt/V was 3.5±0.68. Regarding AKI outcome, 23% of patients presented renal function recovery, 6.6% of patients remained on dialysis after 30 days, and 57.3% of patients died. Age and sepsis were identified as risk factors for death. In urine output, increase of 1 g in nitrogen balance and increase of 500 ml in ultrafiltration after three sessions were identified as protective factors. CONCLUSIONS High-volume peritoneal dialysis is effective for a selected AKI patient group, allowing adequate metabolic and fluid control. Age, sepsis, and urine output as well as nitrogen balance and ultrafiltration after three high-volume peritoneal dialysis sessions were associated significantly with death.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Complications of Acute Peritoneal Dialysis in Children with Acute Kidney Failure

Background: Acute kidney injury is the sudden failure of kidneys to maintain body homeostasis and acute peritoneal dialysis is a life saving bedside mode of its management. However, complications like peritonitis, leakage, obstruction and malposition of catheter can occur during acute peritoneal dialysis. Objectives: To document the immediate complications of acute peritoneal dialysis in childr...

متن کامل

Peritoneal Dialysis Treatment Modality Option in Acute Kidney Injury.

BACKGROUND Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMMARY The interest in PD to manage AKI patients has been increased and PD is n...

متن کامل

Does bioimpedance analysis or measurement of natriuretic peptides aid volume assessment in peritoneal dialysis patients?

Cardiovascular mortality remains the commonest cause of death for peritoneal dialysis patients. As such, preventing persistent hypervolemia is important. On the other hand, hypovolemia may potentially risk episodes of acute kidney injury and loss of residual renal function, a major determinant of peritoneal dialysis technique survival. Bioimpedance has developed from a single-frequency research...

متن کامل

The Acute Temporary Peritoneal Dialysis in Neonates: A Five-Year Experience

Background: The aim of this prospective study was to evaluate the characteristics of patients, treated by acute peritoneal dialysis (PD). We also assessed the indications for PD, PD-associated complications and neonatal outcomes in our patients. Methods: During five years, 30 term newborns underwent temporary cycling PD. The procedure was performed by applying the manual technique. A straight ...

متن کامل

Correlational studies on insulin resistance and leptin gene polymorphisms in peritoneal dialysis patients

Objective(s):The aim of the study was to investigate the relationship between insulin resistance (IR) and leptin (LEP) gene polymorphisms in peritoneal dialysis (PD) patients. Materials and Methods: From July 1, 2011 to August 1, 2011, patients who received chronic PD were chosen and divided into three groups (DM, high HOMR-IR, and low HOMR-IR). Two PCR products of LEP were sequenced and aligne...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Clinical journal of the American Society of Nephrology : CJASN

دوره 7 6  شماره 

صفحات  -

تاریخ انتشار 2012