Singh Vishal, Mishra Satish Chandra, Mallikarjuna Pradeepa Adgoor, Rout Binod Biswajeet
Senior Advisor (Medicine) & Nephrologist, 7 Air Force Hospital, Kanpur Cantt, UP, India.
Consultant (Medicine) & Cardiologist, Army Institute of Cardiothoracic Sciences (AICTS), Pune, India.
Med J Armed Forces India. 2023 Jul-Aug;79(4):458-463. doi: 10.1016/j.mjafi.2020.09.003. Epub 2020 Nov 26.
Peritoneal dialysis (PD) as a modality of renal replacement therapy (RRT) in acute kidney injury (AKI), continues to be underused. We present our experience with PD in patients with AKI.
The data of patients with AKI requiring RRT were retrospectively analyzed. The primary end point was the adequacy of dialysis, and the secondary end point included hemodynamic stability and procedure-related complications.
A total of 32 patients with AKI requiring RRT were included in the study. The mean age and the blood pressure at the time of hospitalization were 65.3 ± 6.73 years and 73.7 ± 8.4 mm Hg, respectively. All the patients required vasopressor support; 26 (81%) patients required ventilator support. RRT was initiated at a mean serum creatinine of 6.24 ± 1.17 mg/dL. Rigid stylet catheter was used in 9 (28.2%) and Tenckhoff catheter in 23 (71.8%) patients. The average daily ultrafiltration and weekly Kt/V achieved were 1701 ± 327 mL and 2.19, respectively; these were significantly higher in survivors. After the initiation of PD, hemodynamic instability was observed in 10 (31.2%) patients. The major therapy-related complication noted was PD peritonitis.
In a resource-poor environment, PD is an effective modality of RRT for AKI.
腹膜透析（PD）作为急性肾损伤（AKI）患者肾脏替代治疗（RRT）的一种方式，其使用率仍然较低。我们介绍我们在AKI患者中应用PD的经验。
对需要RRT的AKI患者的数据进行回顾性分析。主要终点是透析充分性，次要终点包括血流动力学稳定性和与操作相关的并发症。
本研究共纳入32例需要RRT的AKI患者。住院时的平均年龄和血压分别为65.3±6.73岁和73.7±8.4 mmHg。所有患者均需要血管活性药物支持；26例（81%）患者需要呼吸机支持。开始RRT时的平均血清肌酐为6.24±1.17 mg/dL。9例（28.2%）患者使用硬导丝导管，23例（71.8%）患者使用Tenckhoff导管。平均每日超滤量和每周Kt/V分别为1701±327 mL和2.19；幸存者的这些指标明显更高。开始PD后，10例（31.2%）患者出现血流动力学不稳定。观察到的主要与治疗相关的并发症是PD腹膜炎。
在资源匮乏的环境中，PD是AKI患者RRT的一种有效方式。
