Archive | 2019
Continuous-Flow Peritoneal Dialysis as Acute Therapy
Abstract
Abstract Peritoneal dialysis (PD) is a simple, safe, inexpensive, and efficient method for renal replacement and for correction of metabolic disorders and fluid overload in acute kidney injury (AKI) in and out of the intensive care unit. Use of PD in AKI is simplified by placement of a Tenckhoff catheter, which can be accomplished safely at the bedside under local or general anesthesia by nephrologist or surgeon. Some PD modalities, such as high-volume PD (HVPD) and continuous-flow PD (CFPD), 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 in which systemic anticoagulation and/or vascular access are problematic. PD is limited by reduced efficiency compared with extracorporeal techniques that may produce inadequate renal replacement in larger and/or severely hypercatabolic patients. Complications include problems with fluid removal, infection, and possible issues with mechanical ventilation.