Internal Medicine Department, University of São Paulo State, Botucatu School of Medicine-UNESP, São Paulo, Brazil.
Blood Purif. 2012;34(2):107-16. doi: 10.1159/000341648. Epub 2012 Oct 24.
Peritoneal dialysis (PD) is a simple, safe, cheap, and efficient renal replacement therapy method. It can correct metabolic disorders and fluid overload in acute kidney injury (AKI) patients both in and out of the intensive care unit. Use of PD in AKI is enhanced by placement of a Tenckhoff catheter, which can be safely accomplished at the bedside. Some PD modalities, such as high-volume PD and continuous-flow PD, can provide dialysis doses and efficiency comparable to extracorporeal blood purification methods. PD is particularly suitable for neonates, children, and patients with refractory heart failure or who are otherwise hemodynamically unstable. PD should be considered in situations where systemic anticoagulation and/or vascular access are problematic. PD is limited by a lower efficiency that may produce inadequate renal replacement in larger and/or severely hypercatabolic patients. Fluid removal can be unpredictable, there is a risk of infection, and possible issues with mechanical ventilation. In this article, we discuss the use of PD in AKI, with emphasis on recent advances.
腹膜透析（PD）是一种简单、安全、廉价且高效的肾脏替代治疗方法。它可以纠正重症监护病房内外急性肾损伤（AKI）患者的代谢紊乱和液体超负荷。使用 PD 的前提是放置 Tenckhoff 导管，该操作可在床边安全进行。一些 PD 方式，如高容量 PD 和连续流动 PD，可提供与体外血液净化方法相当的透析剂量和效率。PD 特别适用于新生儿、儿童和难治性心力衰竭或其他血流动力学不稳定的患者。在存在全身抗凝和/或血管通路问题的情况下，应考虑 PD。PD 的局限性在于效率较低，可能无法为体型较大和/或严重高代谢患者提供充分的肾脏替代。液体清除可能不可预测，存在感染风险，并且可能会影响机械通气。本文讨论了 PD 在 AKI 中的应用，重点介绍了最近的进展。
