Peritoneal dialysis in the critically ill patient

Area of Science:

• Nephrology
• Critical Care Medicine

Background:

• Acute peritoneal dialysis (PD) utilization is rising annually.
• PD is a preferred renal replacement therapy for hemodynamically unstable patients, those with severe cardiovascular disease, existing PD users, and pediatric populations.

Purpose of the Study:

• To review the indications, methods, monitoring, potential complications, and special considerations for acute peritoneal dialysis.

Main Methods:

• This review synthesizes current knowledge on acute PD, covering patient selection, dialysis delivery methods (cycler vs. manual), and essential monitoring parameters.
• Emphasis is placed on managing potential complications and addressing unique patient needs.

Main Results:

• PD offers a viable alternative for acute kidney injury management in specific patient groups.
• Key monitoring includes volume status, bowel status, and infection prevention.
• Potential complications encompass access issues, infection, pain, respiratory compromise, and electrolyte/fluid imbalances.

Conclusions:

• Acute PD requires vigilant monitoring and management of potential complications.
• Special attention must be paid to nutritional status, drug therapy adjustments, and psychosocial support for patients and families undergoing acute PD.
• Consideration of treatment termination is also an important aspect of care.