Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury

Ponce, Daniela; Balbi, André Luís; Durand, Jonathan B; Moretta, Gustavo; Divino-Filho, José Carolino

doi:10.1093/ckj/sfaa102

Cited by 16 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PD may provide a reasonable alternative for HD or CRRT techniques, especially in case of logistic demands [ 82 ]. In order to reduce exposure of the nursing team, automated peritoneal dialysis may be preferred, when possible with remote patient monitoring software [ 75 ], although, on the other hand, it has been argued that CAPD may have the advantage of lesser catheter problems due to lower flow rates [ 83 ].…”

Section: Some Specific Considerations For Extracorporeal Treatment Inmentioning

confidence: 99%

COVID-19 in ESRD and Acute Kidney Injury

Kooman

Sande²

2020

Blood Purif

View full text Add to dashboard Cite

The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be at increased risk for infection due to viral transmission next to an enhanced risk for mortality as compared to the general population, even in the face of an often apparently mild clinical presentation. Derangements in the innate and adaptive immune systems may be responsible for a reduced antiviral response, whereas chronic activation of the innate immune system and endothelial dysfunction provide a background for a more severe course. The presence of severe comorbidity, older age, and a reduction of organ reserve may lead to a rapid deterioration of the clinical situation of the patients in case of severe infection. Secondly, patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity of the clinical disease. The presence of AKI, and especially the need for renal replacement therapy (RRT), is associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct viral invasion of kidney cells, activation of the renin-angiotensin aldosterone system, a hyperinflammatory response, hypercoagulability, and nonspecific factors such as hypotension and hypoxemia may be involved. Apart from logistic challenges and the need for strict hygiene within units, treatment of patients with ESRD and COVID-19 is not different from that of the general population. Extracorporeal treatment of patients with AKI with RRT can be complicated by frequent filter clotting due to the hypercoagulable state, for which regional citrate coagulation provides a reasonable solution. Also, acute peritoneal dialysis may be a reasonable option in these patients. Whether adjuncts to extracorporeal therapies, such as hemoadsorption, provide additional benefits in the case of severely ill COVID-19 patients needs to be addressed in controlled studies.

show abstract

Section: Some Specific Considerations For Extracorporeal Treatment Inmentioning

confidence: 99%

COVID-19 in ESRD and Acute Kidney Injury

Kooman

Sande²

2020

Blood Purif

View full text Add to dashboard Cite

show abstract

“…119 An editorial mentioning experience of AKI in COVID-19 mentions that a major advantage of PD during this pandemic has been the ability to train non-nursing staff in the PD procedure, which is safe and straightforward. 120 Availability, feasibility, affordability, and safety. Availability of dialysis treatment in LMICs is highly variable.…”

Section: Questionmentioning

confidence: 99%

Pragmatic Recommendations for the Prevention and Treatment of Acute Kidney Injury in Patients with COVID-19 in Low- and Middle-Income Countries

Rudd

Çizmeci

Galli

et al. 2021

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

. Current recommendations for the management of patients with COVID-19 and acute kidney injury (AKI) are largely based on evidence from resource-rich settings, mostly located in high-income countries. It is often unpractical to apply these recommendations to resource-restricted settings. We report on a set of pragmatic recommendations for the prevention, diagnosis, and management of patients with COVID-19 and AKI in low- and middle-income countries (LMICs). For the prevention of AKI among patients with COVID-19 in LMICs, we recommend using isotonic crystalloid solutions for expansion of intravascular volume, avoiding nephrotoxic medications, and using a conservative fluid management strategy in patients with respiratory failure. For the diagnosis of AKI, we suggest that any patient with COVID-19 presenting with an elevated serum creatinine level without available historical values be considered as having AKI. If serum creatinine testing is not available, we suggest that patients with proteinuria should be considered to have possible AKI. We suggest expansion of the use of point-of-care serum creatinine and salivary urea nitrogen testing in community health settings, as funding and availability allow. For the management of patients with AKI and COVID-19 in LMICS, we recommend judicious use of intravenous fluid resuscitation. For patients requiring dialysis who do not have acute respiratory distress syndrome (ARDS), we suggest using peritoneal dialysis (PD) as first choice, where available and feasible. For patients requiring dialysis who do have ARDS, we suggest using hemodialysis, where available and feasible, to optimize fluid removal. We suggest using locally produced PD solutions when commercially produced solutions are unavailable or unaffordable.

show abstract

“…Recently, Ponce et al [ 21 ] published PD prescription recommendations, which highlight the strategies with short cycles for patients with severe hyperkalemia, metabolic acidosis, fluid overload, or uremic symptoms, for which the modalities of HVPD or PD of tide would be the modalities of choice, in this case the total volume of dialysate must reach 30–36 L [ 43 ]. Strategies such as tidal PD may decrease patient monitoring time and therefore lessen exposure in medical personnel.…”

Section: Insights Of Peritoneal Dialysis In Covid-19 Pandemicmentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

In December 2019, cases of acute respiratory illness of unknown origin were reported in Wuhan, China. The disease is caused by “severe acute respiratory syndrome coronavirus 2”. After identifying severe lung damage, injury to other organs, such as the kidney, has been identified. Peritoneal dialysis is a renal replacement therapy (RRT) and is at least as effective as other extracorporeal therapy options, with significant cost-effective advantages. However, this strategy is rarely used for the management of acute kidney injury in severe lung disease. In this review, we explore PD as an RRT strategy that may be a key instrument in countries and hospitals with limited access to all RRTs.

show abstract

Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury

Cited by 16 publications

References 26 publications

COVID-19 in ESRD and Acute Kidney Injury

COVID-19 in ESRD and Acute Kidney Injury

Pragmatic Recommendations for the Prevention and Treatment of Acute Kidney Injury in Patients with COVID-19 in Low- and Middle-Income Countries

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

Contact Info

Product

Resources

About