Outcome of Continuous Peritoneal Dialysis in Patient with Acute Kidney Injury

Amrit Kc, Rahman Tanvir, A. Rafiqul, A. Hamid, Noor Towhida
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Abstract

Background: Though peritoneal dialysis has several limitations, it is still used in acute kidney injury (AKI) patients as an alternative method of Renal Replacement Therapy (RRT), especially in low socioeconomic countries. Materials and Method: This study included thirty patients diagnosed as AKI. Peritoneal access was established through flexible Tenckhoff catheter for Continuous Peritoneal Dialysis (CPD) and 6-8 exchanges were done in 24 hours. Results: Among 30 patients mean age was (mean±SD) 49.93±14.42 years. Seven (23.33%) patients were hemodynamically unstable. The cause of AKI was drug induced in 6(20.7%), hypovolemia/Acute Tubular Necrosis in 6(20.0%), sepsis in 5(16.7%), heart failure in 2(6.7%) and 11(36.7%) had multiple causes. In initial presentation, mean serum creatinine was 683.42 μmol/L, and the number of sessions required for stabilization of serum creatinine was 7.5±1.43, sessions required for correction of hyperkalemia and metabolic acidosis were 2.15±0.69 and 2.5±0.76 respectively. The delivered Kt/V urea was 1.95±0.14 weekly. Six (20.0%) patients had peritonitis, five (16.7%) had pericatheter leakage and four (13.33%) had catheter blockage. Among 30 patients, three patients (10%) had died, sixteen (59.3%) had recovery of renal function and rest did not recover renal function. Conclusion: CPD was effective for correction of metabolic and electrolyte imbalance.  
急性肾损伤患者持续腹膜透析的疗效
背景:尽管腹膜透析有一些局限性,但它仍然被用于急性肾损伤(AKI)患者作为肾脏替代治疗(RRT)的替代方法,特别是在低社会经济国家。材料与方法:本研究纳入30例AKI患者。通过柔性Tenckhoff导管建立持续腹膜透析(CPD)的腹膜通路,24小时内进行6-8次交换。结果:30例患者平均年龄(mean±SD) 49.93±14.42岁。7例(23.33%)患者血流动力学不稳定。AKI病因为药物所致6例(20.7%),低血容量/急性肾小管坏死6例(20.0%),脓毒症5例(16.7%),心力衰竭2例(6.7%),多病因11例(36.7%)。初始表现时,平均血清肌酐为683.42 μmol/L,稳定血清肌酐所需时间为7.5±1.43次,纠正高钾血症和代谢性酸中毒所需时间分别为2.15±0.69次和2.5±0.76次。每周输送的Kt/V尿素为1.95±0.14。腹膜炎6例(20.0%),导管外漏5例(16.7%),导管堵塞4例(13.33%)。30例患者中死亡3例(10%),肾功能恢复16例(59.3%),其余患者肾功能未恢复。结论:CPD能有效纠正代谢和电解质失衡。
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