Acute PD: Evidence, Guidelines, and Controversies^☆

Area of Science:

• Nephrology
• Critical Care Medicine

Background:

• Peritoneal dialysis (PD) was once a common treatment for acute kidney injury (AKI) but declined with the rise of extracorporeal therapies.
• Renewed interest in PD for AKI is driven by its cost-effectiveness and minimal infrastructure needs, particularly in developing countries.

Purpose of the Study:

• To review the technical advancements, clinical advantages, and limitations of using PD for AKI treatment.
• To discuss recent literature and the impact of new guidelines on PD for AKI.

Main Methods:

• Review of recent literature on clinical experiences with PD in AKI patients.
• Discussion of technical aspects, including cyclers, flexible catheters, and high-volume fluid use.
• Consideration of challenges in developing countries, such as research infrastructure limitations.

Main Results:

• PD is a feasible and safe alternative for AKI, with improved outcomes due to technological advancements.
• Studies from developing countries demonstrate successful PD treatment in critically ill patients.
• New guidelines aim to standardize PD indications, dosing, and management of complications in AKI.

Conclusions:

• Peritoneal dialysis is a viable and increasingly utilized option for managing acute kidney injury, particularly where resources are limited.
• Ongoing research and updated guidelines are crucial for optimizing PD therapy in AKI and addressing evidence gaps.