Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center
| Autor: | Satish Jayawardene, Kate Bramham, Elaine Bowes, Jennifer Joslin, Philip Hopkins, Hugh Cairns, Eirini Lioudaki, Sam Hutchings, Babakang Shakoane, Sujit Saha, Catriona Shaw, Caroline Tulley, D. B. Braide-Azikiwe, C. Jason Wilkins, Claire C. Sharpe |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Percutaneous
medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology lcsh:RC870-923 urologic and male genital diseases law.invention Peritoneal dialysis 03 medical and health sciences 0302 clinical medicine law Clinical Research Intensive care medicine Renal replacement therapy percutaneous catheter insertion Catheter insertion business.industry Acute kidney injury COVID-19 lcsh:Diseases of the genitourinary system. Urology medicine.disease Intensive care unit Catheter acute kidney injury peritoneal dialysis Nephrology Anesthesia business |
| Zdroj: | Kidney International Reports Kidney International Reports, Vol 6, Iss 2, Pp 265-271 (2021) |
| ISSN: | 2468-0249 |
| DOI: | 10.1016/j.ekir.2020.11.038 |
| Popis: | Introduction During the coronavirus disease 2019 (COVID-19) pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to an increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving challenging, and so alternatives to continuous renal replacement therapies (CRRT) in the intensive care unit (ICU) are needed. Peritoneal dialysis (PD) can be initiated immediately after percutaneous insertion of the catheter, but there are concerns about impact on ventilation and RRT efficacy. We sought to describe our recent experience with percutaneous catheter insertion and peritoneal dialysis in patients in the ICU with COVID-19 infection. Method Patients were selected according to local protocol, and catheters were inserted percutaneously by experienced operators using a Seldinger technique. Sequential Organ Failure Assessment (SOFA) score and ventilation requirements were recorded at the time of insertion and 24 hours later. Procedural complications, proportion of RRT provided by PD, renal recovery, and RRT parameters (serum potassium and maximum base excess) during PD were assessed. Results Percutaneous PD catheters were successfully inserted in 37 of 44 patients (84.1%) after a median of 13.5 days (interquartile range [IQR] = 10.0, 20.3 days) in the ICU. No adverse events were reported; SOFA scores and ventilation requirements were comparable before and after insertion; and adequate RRT parameters were achieved. The median proportion of RRT provided by PD following catheter insertion was 94.6% (IQR = 75.0, 100%). Conclusion Peritoneal dialysis provides a safe and effective alternative to CRRT in selected patients with AKI and COVID-19 infection requiring ventilation on intensive care. Graphical abstract |
| Databáze: | OpenAIRE |
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