Peritoneal Dialysis during the COVID-19 Pandemic Is an Effective Treatment in Developing Countries: A Report from Mexico

Abstract

<b><i>Introduction:</i></b> During the height of the coronavirus disease-19 (COVID-19) pandemic, some renal replacement therapy (RRT) modalities were insufficient, forcing medical centers to diversify the RRT modalities offered. In this study, we reported the outcomes of chronic peritoneal dialysis (PD) patients and acute PD in critically ill patients during COVID-19 pandemic in a tertiary care medical center in Mexico. <b><i>Methods:</i></b> This descriptive, longitudinal, observational, retrospective study included 47 adult patients with atypical pneumonia in a tertiary care medical center in Mexico during the first and second waves of the COVID-19 pandemic. Chronic PD patients and PD incident patients due to acute kidney injury (AKI) were included. <b><i>Results:</i></b> Forty-seven patients were studied (29 chronic PD patients and 18 incident PD patients due to AKI); median age was 59 (48–68) years; 63.8% were men. The ultrafiltrate volume per day was 815 (596.1–1,193.2) mL. Overall mortality was 61.7%, 55.2% in chronic PD patients, and 72.2% in PD incident patients due to AKI. A higher Sequential Organ Failure Assessment (SOFA) score, the need for mechanical ventilation at admission, and the requirement for vasopressors were predictors for mortality (<i>p</i> < 0.01). <b><i>Conclusion:</i></b> In low- and lower-middle-income countries, PD was a valid alternative for RRT during the COVID-19 pandemic. In AKI patients, PD can correct hyperkalemia, acidosis, uremia, and volume overload; however, there was higher mortality in PD incident patients due to AKI. The main risk factors for mortality were a high SOFA score at admission, the need for invasive mechanical ventilation, and the requirement for vasopressors.

The Importance of Natural and Acquired Immunity to SARS-CoV-2 Infection in Patients on Peritoneal Dialysis

“…The peritoneal membrane has various pores, and large pores with a radius of 250 Å, which play a role in the transcapillary transport of macromolecules, such as proteins and immunoglobulins (Ig), by the process of active transport, and represent only 0.01% of the total [4]. During the period of the COVID-19 pandemic, a small number of studies explored the impact and significance of the pandemic in PD patients [5]. During the immunization period, different vaccines against SARS-CoV-2 (neutralizing, vector and Vaccines 2024, 12, 135 2 of 13 mRNK) were available in the Republic of Serbia: inactivated virus vaccine (Sinopharm, Beijing, China), mRNA vaccine (Pfizer/BioNTech, New York, NY, USA) and adenovirus vector vaccines (Sputnik-V (Moscow, Russia) and Oxford-AstraZeneca (Cambridge, England, UK)) [6].…”