Use of Peritoneal Dialysis in Acute Kidney Injury: How Far Away?

Area of Science:

• Nephrology
• Public Health
• Renal Replacement Therapy

Background:

• Acute kidney injury (AKI) is a global health concern with high mortality and progression to chronic kidney disease.
• Peritoneal dialysis (PD) presents a viable renal support option for AKI, especially in resource-limited settings.
• Despite its potential, PD for AKI is currently underused worldwide.

Purpose of the Study:

• To discuss the existing barriers and challenges hindering the widespread adoption of PD in AKI management.
• To identify key areas for improvement in health strategy, medical resources, and PD team organization for acute PD.
• To highlight technique-specific factors influencing the use of PD in AKI.

Main Methods:

• Review and discussion of current literature and clinical practices regarding PD for AKI.
• Analysis of systemic and technical factors impacting PD implementation in acute settings.
• Identification of strategic and organizational challenges in acute PD programs.

Main Results:

• Significant barriers exist in health strategy, medical resource allocation, and PD team organization for acute PD.
• Technique-specific challenges also contribute to the underutilization of PD in AKI.
• The current application of PD for AKI is in its nascent stages, indicating a need for further development.

Conclusions:

• The implementation of PD for AKI faces multifaceted challenges, including strategic, resource-related, organizational, and technical factors.
• There is a substantial need for strategic initiatives and resource development to promote PD as a mature treatment for AKI.
• Further research and development are required to fully realize the potential of acute PD in global renal replacement therapy.