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Published on: July 19, 2018
High volume peritoneal dialysis for acute renal failure
Daniela Ponce Gabriel1, Ginivaldo Victor Ribeiro do Nascimento, Jacqueline Teixeira Caramori
1Department of Internal Medicine, University Hospital, Botucatu School of Medicine, São Paulo State University, Rubião Júnior, CEP 18618-970 São Paulo, SP, Brazil. dponcegabriel@uol.com.br
Summary
High-dose continuous peritoneal dialysis (PD) effectively manages acute renal failure (ARF) by improving metabolic control and fluid balance. This method offers a viable alternative to other renal replacement therapies for ARF patients.
Area of Science:
- Nephrology
- Critical Care Medicine
Background:
- Peritoneal dialysis (PD) remains a common treatment for acute renal failure (ARF) in developing nations, despite questions regarding its efficacy.
- Continuous PD has been investigated for ARF, focusing on metabolic and acid-base balance.
Purpose of the Study:
- To evaluate the effectiveness of high-dose continuous PD in treating acute renal failure.
- To assess metabolic control, fluid removal, and patient outcomes in ARF patients undergoing continuous PD.
Main Methods:
- A prospective study involved 30 ARF patients treated with high-dose continuous PD (Kt/V = 0.65/session) using a Tenckhoff catheter and automated cycler.
- Evaluated parameters included fluid removal, pH and metabolic status, protein loss, and patient outcomes.
Main Results:
- Continuous PD sessions (236 total) led to stabilization of BUN, creatinine, bicarbonate, and pH within 2-4 sessions.
- Adequate fluid removal (2.1 L/day) and solute clearance (creatinine 15.8 mL/min, urea 17.3 mL/min) were achieved.
- Despite significant protein loss (median 21.7 g/day), serum albumin remained stable. Renal function recovery occurred in 23% of patients, with a 57% mortality rate.
Conclusions:
- High-dose continuous PD with a flexible catheter and cycler is effective for ARF.
- It ensures high solute removal, metabolic and pH control, and sufficient dialysis and fluid management.
- Continuous PD presents a viable alternative to other renal replacement therapies for ARF.
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