Acute peritoneal dialysis in COVID-19

Parapiboon, Watanyu; Ponce, Daniela; Cullis, Brett

doi:10.1177/0896860820931235

Cited by 25 publications

(36 citation statements)

References 27 publications

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“…However, in times of pandemics, minimum physical contact between health-care providers and the highly contagious COVID-19 positive patient is warranted. Thus, APD compared to CAPD is probably preferred; since it can be implemented only once daily, the patient can be remotely monitored and the cycler setup can be prepared at a distance from the patient [109].…”

Section: Pd During Emergencies Pandemics and Natural Disastersmentioning

confidence: 99%

APD or CAPD: one glove does not fit all

Roumeliotis

Leivaditis

et al. 2020

Int Urol Nephrol

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The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality. Improved patients' compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis have been also associated with APD. However, concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep are APD's setbacks. Besides APD superiority over CAPD in fast transporters, the other medical advantages of APD still remain controversial. In any case, APD should be readily available for all patients starting PD and the most important indication for its implementation remains patient's choice.

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Section: Pd During Emergencies Pandemics and Natural Disastersmentioning

confidence: 99%

APD or CAPD: one glove does not fit all

Roumeliotis

Leivaditis

et al. 2020

Int Urol Nephrol

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“…the treatment of AKI in COVID-19, as it requires minimal staff training, minimizing exposure to contagious patients; involves less use of personal protective equipment (PPE), is not affected by hypercoagulability, does not requires a vascular access, and offers more hemodynamic stability than IH (5). Furthermore, one advantage is that percutaneous catheter insertion does not require general anesthesia; therefore, it compromised less the respiratory function (4).…”

Section: Read Full Licensementioning

confidence: 99%

Detection of SARS-CoV-2 in peritoneal fluid from patients with kidney disease and COVID-19: report of two cases

Ibarra-Hernandez

Alcantar-Vallín

Cabrera-Silva

et al. 2020

Preprint

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Background: Coronavirus disease-2019 (COVID-19) has a broad clinical presentation, involving multiple organs besides the respiratory system. Currently, there is little evidence available on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in peritoneal fluid (PF). In this study, we describe the detection of SARS-CoV-2 in the PF of two patients with COVID 19 and kidney disease.Case presentation: Case 1: A 71-year-old woman with a history of end-stage kidney disease who presented with a 15-day evolution of progressive dyspnea, accompanied by dry cough and fever; IgM antibodies to SARS-CoV-2 were detected on admission. Real-time SARS-CoV-2 polymerase chain reaction (qRT-PCR) in the PF was positive. Three days after admission the patient's respiratory distress improved and she was discharged after 8 days of hospitalization.Case 2: A 78-year-old woman, with type 2 diabetes, hypertension, a 15-day history of polypnea, and a 5-day onset of fever and dyspnea. IgM and IgG antibodies to SARS-CoV-2 were detected on admission, as well as a positive nasopharyngeal qRT-PCR test for SARS-CoV-2. During hospitalization she developed acute kidney injury, requiring peritoneal dialysis, SARS-CoV-2 was confirmed in PF by qRT-PCRConclusions: These two cases highlights the importance of increasing the level of awareness for the presence and possible SARS-CoV-2 transmission through non-respiratory routes, like peritoneal fluid.Emphasis should be given to appropriate preventive strategies for minimizing the risk of transmission of COVID-19 from patients on peritoneal dialysis in both inpatient and outpatient settings.

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“…Sometimes, shorter cycles may be desired, for example, if poor ultrafiltration was observed with longer dwells. Equations (5) and (7) can be used to estimate the total V D and v dwell per cycle based on a desired t dwell .…”

Section: Practical Applications Of the Equationsmentioning

confidence: 99%

“…3,4 The shortage of intensive care unit (ICU) beds, continuous renal replacement therapy (CRRT) machines, and specialized staff has compelled many to consider acute PD. [5][6][7][8] While outcome data are limited, acute PD appears to be as effective as other forms of dialysis for the management of AKI. 9,10 The amount or dose of PD to effectively treat patients with AKI is not clear.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal dialysis for acute kidney injury: Equations for dosing in pandemics, disasters, and beyond

2020

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Background: Peritoneal dialysis (PD) is a viable option for renal replacement therapy in acute kidney injury (AKI), especially in challenging times during disasters and pandemics when resources are limited. While PD techniques are well described, there is uncertainty about how to determine the amount of PD to be prescribed toward a target dose. The aim of this study is to derive practical equations to assist with the prescription of PD for AKI. Methods: Using established physiological principles behind PD clearance and membrane transport, a primary determinant of dose delivery, equations were mathematically derived to estimate dialysate volume required to achieve a target dose of PD. Results: The main derivative equation is VD = (1.2 × std- Kt/ V × TBW)/( t dwell + 4), where VD is the total dialysate volume per day, std- Kt/ V is the desired weekly dose, TBW is the total body water, and t dwell is the dwell time. VD can be expressed in terms of dwell volume, v dwell, by VD = (0.3 × std- Kt/ V × TBW) − (6 × v dwell). Two further equations were derived which directly describe the mathematical relationship between t dwell and v dwell. A calculator is included as an Online Supplementary Material. Conclusions: The equations are intended as a practical tool to estimate solute clearances and guide prescription of continuous PD. The estimated dialysate volume required for any dose target can be calculated from cycle duration or dwell volume. However, the exact target dose of PD is uncertain and should be adjusted according to the clinical circumstances and response to treatment. The equations presented in this article facilitate the adjustment of PD prescription toward the targeted solute clearance.

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Acute peritoneal dialysis in COVID-19

Cited by 25 publications

References 27 publications

APD or CAPD: one glove does not fit all

APD or CAPD: one glove does not fit all

Detection of SARS-CoV-2 in peritoneal fluid from patients with kidney disease and COVID-19: report of two cases

Peritoneal dialysis for acute kidney injury: Equations for dosing in pandemics, disasters, and beyond

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