Peritoneal Dialysis Is an Option for Acute Kidney Injury Management in Patients with COVID-19

Rodríguez-Chagolla, José Manuel; Vásquez-Jiménez, Enzo; Arellano, Leticia Herrera; Torres, Alberto Villa; García, Nayeli Acosta; Quimbiulco, D. Alemán; Aguilar, Sergio; Madero, Magdalena

doi:10.1159/000511390

Cited by 4 publications

(4 citation statements)

References 37 publications

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“…The socioeconomic burden of RRT is high, since conventional HD is rather costly for healthcare providers, with substantial differences in funds available per capita across different countries (58). As alternative to HD (8), PD is a well-established and viable option for home RRT, which minimizes potential virus exposure and the associated health risks (10)(11)(12)(13)(14)(15). However, its long-term use is limited due to the decline in peritoneal ultrafiltration that typically occurs 2-4 years after initiation of PD (22).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with kidney failure requiring regular renal replacement therapy (RRT) are at particular risk of infection and Coronavirus-induced disease 2019 (COVID-19) (5)(6)(7). In addition to commonly used hemodialysis (HD) (Figure 1A), peritoneal dialysis (PD) (Figure 1B) is a valuable cost-effective 'home-care' RRT, which combines patients' independence from HD centres with self-isolation, and thus is of particular interest during the COVID-19 pandemic (10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Angiogenic Role of Mesothelium-Derived Chemokine CXCL1 During Unfavorable Peritoneal Tissue Remodeling in Patients Receiving Peritoneal Dialysis as Renal Replacement Therapy

et al. 2022

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Peritoneal dialysis (PD) is a valuable ‘home treatment’ option, even more so during the ongoing Coronavirus pandemic. However, the long-term use of PD is limited by unfavourable tissue remodelling in the peritoneal membrane, which is associated with inflammation-induced angiogenesis. This appears to be driven primarily through vascular endothelial growth factor (VEGF), while the involvement of other angiogenic signaling pathways is still poorly understood. Here, we have identified the crucial contribution of mesothelial cell-derived angiogenic CXC chemokine ligand 1 (CXCL1) to peritoneal angiogenesis in PD. CXCL1 expression and peritoneal microvessel density were analysed in biopsies obtained by the International Peritoneal Biobank (NCT01893710 at www.clinicaltrials.gov), comparing 13 children with end-stage kidney disease before initiating PD to 43 children on chronic PD. The angiogenic potential of mesothelial cell-derived CXCL1 was assessed in vitro by measuring endothelial tube formation of human microvascular endothelial cells (HMECs) treated with conditioned medium from human peritoneal mesothelial cells (HPMCs) stimulated to release CXCL1 by treatment with either recombinant IL-17 or PD effluent. We found that the capillary density in the human peritoneum correlated with local CXCL1 expression. Both CXCL1 expression and microvessel density were higher in PD patients than in the age-matched patients prior to initiation of PD. Exposure of HMECs to recombinant CXCL1 or conditioned medium from IL-17-stimulated HPMCs resulted in increased endothelial tube formation, while selective inhibition of mesothelial CXCL1 production by specific antibodies or through silencing of relevant transcription factors abolished the proangiogenic effect of HPMC-conditioned medium. In conclusion, peritoneal mesothelium-derived CXCL1 promotes endothelial tube formation in vitro and associates with peritoneal microvessel density in uremic patients undergoing PD, thus providing novel targets for therapeutic intervention to prolong PD therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Angiogenic Role of Mesothelium-Derived Chemokine CXCL1 During Unfavorable Peritoneal Tissue Remodeling in Patients Receiving Peritoneal Dialysis as Renal Replacement Therapy

et al. 2022

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“…Some studies have demonstrated susceptibility to infection in patients undergoing PD, although the reported cases are less frequent than in hemodialyzed patients [ 235 ]. However, PD could represent a more practical and safer KRT method for CKD patients, considering a home-safer option during the pandemic crisis [ 236 ]. In this sense, a recent cohort population study of PD patients pointed out that this KRT does not increase the risk of infection for SARS-CoV-2.…”

Section: Covid-19 In Ckd Patients Under Krt and In Mesotheliummentioning

confidence: 99%

Novel Aspects of the Immune Response Involved in the Peritoneal Damage in Chronic Kidney Disease Patients under Dialysis

Trionfetti

Marchant

González-Mateo

et al. 2023

IJMS

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Chronic kidney disease (CKD) incidence is growing worldwide, with a significant percentage of CKD patients reaching end-stage renal disease (ESRD) and requiring kidney replacement therapies (KRT). Peritoneal dialysis (PD) is a convenient KRT presenting benefices as home therapy. In PD patients, the peritoneum is chronically exposed to PD fluids containing supraphysiologic concentrations of glucose or other osmotic agents, leading to the activation of cellular and molecular processes of damage, including inflammation and fibrosis. Importantly, peritonitis episodes enhance peritoneum inflammation status and accelerate peritoneal injury. Here, we review the role of immune cells in the damage of the peritoneal membrane (PM) by repeated exposure to PD fluids during KRT as well as by bacterial or viral infections. We also discuss the anti-inflammatory properties of current clinical treatments of CKD patients in KRT and their potential effect on preserving PM integrity. Finally, given the current importance of coronavirus disease 2019 (COVID-19) disease, we also analyze here the implications of this disease in CKD and KRT.

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“…During the height of the pandemic, some RRT modalities were insufficient, forcing medical centers to diversify the RRT modalities offered. In regions of low- and lower-middle-income countries, peritoneal dialysis (PD) during the COVID-19 pandemic is an alternative to be considered [5, 6]. In Mexico, PD is the first alternative and the main RRT therapy, especially within health institutions.…”

Section: Introductionmentioning

confidence: 99%

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

Villa-Torres,

Vásquez-Jiménez,

Velazquez-Silva

et al. 2023

Blood Purif

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Introduction: 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. Methods: 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. Results: 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 (p < 0.01). Conclusion: 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.

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Peritoneal Dialysis Is an Option for Acute Kidney Injury Management in Patients with COVID-19

Cited by 4 publications

References 37 publications

Angiogenic Role of Mesothelium-Derived Chemokine CXCL1 During Unfavorable Peritoneal Tissue Remodeling in Patients Receiving Peritoneal Dialysis as Renal Replacement Therapy

Angiogenic Role of Mesothelium-Derived Chemokine CXCL1 During Unfavorable Peritoneal Tissue Remodeling in Patients Receiving Peritoneal Dialysis as Renal Replacement Therapy

Novel Aspects of the Immune Response Involved in the Peritoneal Damage in Chronic Kidney Disease Patients under Dialysis

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

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