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Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19-Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center.
Bowes, Elaine; Joslin, Jennifer; Braide-Azikiwe, Dandisonba C B; Tulley, Caroline; Bramham, Kate; Saha, Sujit; Jayawardene, Satish; Shakoane, Babakang; Wilkins, C Jason; Hutchings, Sam; Hopkins, Philip; Lioudaki, Eirini; Shaw, Catriona; Cairns, Hugh; Sharpe, Claire C.
  • Bowes E; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Joslin J; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Braide-Azikiwe DCB; Faculty of Life Sciences and Medicine, King's College London, UK.
  • Tulley C; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Bramham K; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Saha S; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Jayawardene S; Faculty of Life Sciences and Medicine, King's College London, UK.
  • Shakoane B; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Wilkins CJ; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Hutchings S; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Hopkins P; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Lioudaki E; Faculty of Life Sciences and Medicine, King's College London, UK.
  • Shaw C; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Cairns H; Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
  • Sharpe CC; King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.
Kidney Int Rep ; 6(2): 265-271, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1056576
Semantic information from SemMedBD (by NLM)
1. Implantation procedure USES CATHETE
Subject
Implantation procedure
Predicate
USES
Object
CATHETE
2. Implantation procedure TREATS Kidney Failur
Subject
Implantation procedure
Predicate
TREATS
Object
Kidney Failur
3. Implantation procedure COEXISTS_WITH intensive care
Subject
Implantation procedure
Predicate
COEXISTS_WITH
Object
intensive care
4. unwellness PROCESS_OF Patients
Subject
unwellness
Predicate
PROCESS_OF
Object
Patients
5. Kidney Failur PROCESS_OF C0030705
Subject
Kidney Failur
Predicate
PROCESS_OF
Object
C0030705
6. Implantation procedure AFFECTS Respiration
Subject
Implantation procedure
Predicate
AFFECTS
Object
Respiration
7. Implantation procedure PRECEDES Peritoneal Dialysis
Subject
Implantation procedure
Predicate
PRECEDES
Object
Peritoneal Dialysis
8. Experience PROCESS_OF Patients
Subject
Experience
Predicate
PROCESS_OF
Object
Patients
9. Seldinger technique ADMINISTERED_TO Patients
Subject
Seldinger technique
Predicate
ADMINISTERED_TO
Object
Patients
10. Serum LOCATION_OF potassium
Subject
Serum
Predicate
LOCATION_OF
Object
potassium
11. Peritoneal Dialysis METHOD_OF Renal Replacement Therapy
Subject
Peritoneal Dialysis
Predicate
METHOD_OF
Object
Renal Replacement Therapy
12. Catheterization PRECEDES Peritoneal Dialysis
Subject
Catheterization
Predicate
PRECEDES
Object
Peritoneal Dialysis
13. Continuous Renal Replacement Therapy TREATS Kidney Failur
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Kidney Failur
14. Continuous Renal Replacement Therapy TREATS COVID-19
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
COVID-19
15. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
16. Continuous Renal Replacement Therapy TREATS Patients
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Patients
17. Implantation procedure USES CATHETER, PERCUTANEOUS
Subject
Implantation procedure
Predicate
USES
Object
CATHETER, PERCUTANEOUS
18. Implantation procedure TREATS Kidney Failure, Acute
Subject
Implantation procedure
Predicate
TREATS
Object
Kidney Failure, Acute
19. Implantation procedure COEXISTS_WITH intensive care
Subject
Implantation procedure
Predicate
COEXISTS_WITH
Object
intensive care
20. unwellness PROCESS_OF Patients
Subject
unwellness
Predicate
PROCESS_OF
Object
Patients
21. Kidney Failure, Acute PROCESS_OF Patients
Subject
Kidney Failure, Acute
Predicate
PROCESS_OF
Object
Patients
22. Implantation procedure AFFECTS Respiration
Subject
Implantation procedure
Predicate
AFFECTS
Object
Respiration
23. Implantation procedure PRECEDES Peritoneal Dialysis
Subject
Implantation procedure
Predicate
PRECEDES
Object
Peritoneal Dialysis
24. Experience PROCESS_OF Patients
Subject
Experience
Predicate
PROCESS_OF
Object
Patients
25. Seldinger technique ADMINISTERED_TO Patients
Subject
Seldinger technique
Predicate
ADMINISTERED_TO
Object
Patients
26. Serum LOCATION_OF potassium
Subject
Serum
Predicate
LOCATION_OF
Object
potassium
27. Peritoneal Dialysis METHOD_OF Renal Replacement Therapy
Subject
Peritoneal Dialysis
Predicate
METHOD_OF
Object
Renal Replacement Therapy
28. Catheterization PRECEDES Peritoneal Dialysis
Subject
Catheterization
Predicate
PRECEDES
Object
Peritoneal Dialysis
29. Continuous Renal Replacement Therapy TREATS Kidney Failure, Acute
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Kidney Failure, Acute
30. Continuous Renal Replacement Therapy TREATS COVID-19
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
COVID-19
31. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
32. Continuous Renal Replacement Therapy TREATS Patients
Subject
Continuous Renal Replacement Therapy
Predicate
TREATS
Object
Patients
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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Clinical Practice Guide / Risk factors Language: English Journal: Kidney Int Rep Year: 2021 Document Type: Article Affiliation country: J.ekir.2020.11.038

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Clinical Practice Guide / Risk factors Language: English Journal: Kidney Int Rep Year: 2021 Document Type: Article Affiliation country: J.ekir.2020.11.038