Peritoneal Dialysis in Acute Renal Failure

Passadakis, Ploumis; Dg, Oreopoulos

doi:10.1177/039139880302600401

Cited by 14 publications

(25 citation statements)

References 45 publications

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“…Our results are similar to the results of previous studies that showed that PD clearance was limited by dialysate flow, membrane permeability, and area (6)(7)(8)(9)(10)(11)(20)(21)(22)(23)(24)(25)(31)(32)(33)(34)(35). A 2-L exchange with a dwell time of 30 minutes can achieve dialysate saturation of around 50%.…”

Section: Discussionsupporting

confidence: 90%

“…There are few studies on PD in AKI patients, and most studies present conflicting results (6)(7)(8)(9)(10)(11)(20)(21)(22)(23)(24)(25)(26)(27)(28). The work by Chitalia et al (22) elegantly showed that tidal PD and continuous PD should be adequate methods to keep BUN levels around 65 mg/dl in mildly and moderately (24) reported that intermittent PD was not adequate to maintain BUN levels higher than 75 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

“…Exclusion criteria were age under 18 years, severe CKD (baseline serum creatinine.4 mg/dl), renal transplantation, pregnancy, severe hypercatabolism according to the criteria of Schrier (13), absolute contraindication for PD such as recent abdominal surgery (,1 month), multiple abdominal surgeries (more than three), severe hyperkalemia with electrocardiogram changes, severe respiratory failure (FiO 2 .70%), severe fluid overload, and patients submitted to less than one session of HVPD (6,9,11). If patients presented any one of these contraindications, they were treated by intermittent conventional, prolonged, or continuous hemodialysis (HD) according to their hemodynamic instability.…”

Section: Study Populationmentioning

confidence: 99%

“…However, it is also true that PD is not the most efficient therapy: clearance per exchange can decrease if a shorter dwell time is applied, a lower efficiency can be observed in large-sized and severely hypercatabolic patients, fluid removal can be limited, and there is a high risk of infection and possibility of PD worsening mechanical ventilation, thus impairing respiratory performance (7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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High-Volume Peritoneal Dialysis in Acute Kidney Injury

Ponce

Berbel

Góes

et al. 2012

Clinical Journal of the American Society of Nephrology

111

109

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Summary 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.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

High-Volume Peritoneal Dialysis in Acute Kidney Injury

Ponce

Berbel

Góes

et al. 2012

Clinical Journal of the American Society of Nephrology

111

109

View full text Add to dashboard Cite

show abstract

“…In 1970, acute PD was widely accepted for AKI treatment, but its practice progressively declined in favor of hemodialysis techniques until, currently, PD is underutilized for AKI around the world (2)(3)(4). Recently, Brazilian experiences with PD in AKI have been published, and interest in using PD to manage selected AKI patients has been increasing.…”

mentioning

confidence: 99%