D'Souza Amith Vijay Leon, Raveendran Nishad, Tanwar Rajendra Singh, Kimmatkar Piyush, Beniwal Pankaj, Agarwal Dhananjai, Vinay Vinay
Senior Resident.
Associate Professor.
J Assoc Physicians India. 2017 Jul;65(7):28-31.
Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings.
In this prospective study conducted over a year, patients with AKI due to various aetiologies were subjected to Acute stylet PD. The clinical Outcome, demographic, biochemical and treatment data was assessed. Descriptive statistics was used to analyze the data.
A total of 79 (41 anuric, 33 oliguric and 5 nonoliguric) patients were included in the study. Sepsis was the predominant cause of AKI. Recovery was seen in 34% of patients. Patients with relatively preserved urine output recovered with PD in comparison to the anuric patients (p value <0.01). 58% of patients, majority of whom were anuric needed Hemodialysis (HD) in due course (7 ± 3 days) of time. The mortality in our study was 7.5%.
Acute stylet PD can be considered as a modality of Renal Replacement Therapy (RRT) to treat a selected (oliguric, nonoliguric) group of AKI patients and as a bridge therapy for HD in those AKI patients in anuria.
急性肾损伤（AKI）的死亡率很高。在发展中国家，由于缺乏透析设施及相关费用，AKI导致的死亡率很高。国际肾脏病学会（ISN）“25 by 0”倡议的主要目标是消除AKI导致的死亡。在这种情况下，腹膜透析是一种未得到充分利用的治疗方式。本研究的目的是探讨在资源有限的环境中启动急性短管腹膜透析（PD）的有效性。
在这项为期一年的前瞻性研究中，对各种病因导致的AKI患者进行急性短管PD治疗。评估临床结局、人口统计学、生化和治疗数据。采用描述性统计分析数据。
共有79例患者（41例无尿、33例少尿和5例非少尿）纳入研究。脓毒症是AKI的主要病因。34%的患者病情得到缓解。与无尿患者相比，尿量相对保留的患者通过PD治疗病情得到缓解（p值<0.01）。58%的患者，其中大多数为无尿患者，在适当的时候（7±3天）需要进行血液透析（HD）。本研究中的死亡率为7.5%。
急性短管PD可被视为一种肾脏替代治疗（RRT）方式，用于治疗特定的（少尿、非少尿）AKI患者群体，并作为无尿AKI患者HD的过渡治疗。
