Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center

Elaine Bowes, Jen Joslin, Dandisonba Braide-Azikiwe, Caroline Tulley, Kate Bramham, Sujit Saha, Satish Jayawardene, Babakang Shakoane, C. Jason Wilkins, Sam Hutchings, Philip Hopkins, Eirini Lioudaki, Catriona Shaw, Hugh Cairns, Claire Sharpe

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numberEKIR_1245
Pages (from-to)265-271
Number of pages7
JournalKidney International Reports
Volume6
Issue number2
DOIs
Publication statusPublished - 6 Feb 2021

Keywords

  • Acute Kidney Injury
  • COVID-19
  • percutaneous catheter insertion
  • peritoneal dialysis

Fingerprint

Dive into the research topics of 'Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center'. Together they form a unique fingerprint.

Cite this