Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center
Introduction: During the coronavirus disease 2019 (COVID-19) pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to an increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving chal...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | Kidney International Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024920317952 |
| _version_ | 1818459946586472448 |
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| author | Elaine Bowes Jennifer Joslin Dandisonba C.B. Braide-Azikiwe Caroline Tulley Kate Bramham Sujit Saha Satish Jayawardene Babakang Shakoane C. Jason Wilkins Sam Hutchings Philip Hopkins Eirini Lioudaki Catriona Shaw Hugh Cairns Claire C. Sharpe |
| author_facet | Elaine Bowes Jennifer Joslin Dandisonba C.B. Braide-Azikiwe Caroline Tulley Kate Bramham Sujit Saha Satish Jayawardene Babakang Shakoane C. Jason Wilkins Sam Hutchings Philip Hopkins Eirini Lioudaki Catriona Shaw Hugh Cairns Claire C. Sharpe |
| author_sort | Elaine Bowes |
| collection | DOAJ |
| description | Introduction: During the coronavirus disease 2019 (COVID-19) pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to an increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving challenging, and so alternatives to continuous renal replacement therapies (CRRT) in the intensive care unit (ICU) are needed. Peritoneal dialysis (PD) can be initiated immediately after percutaneous insertion of the catheter, but there are concerns about impact on ventilation and RRT efficacy. We sought to describe our recent experience with percutaneous catheter insertion and peritoneal dialysis in patients in the ICU with COVID-19 infection. Method: Patients were selected according to local protocol, and catheters were inserted percutaneously by experienced operators using a Seldinger technique. Sequential Organ Failure Assessment (SOFA) score and ventilation requirements were recorded at the time of insertion and 24 hours later. Procedural complications, proportion of RRT provided by PD, renal recovery, and RRT parameters (serum potassium and maximum base excess) during PD were assessed. Results: Percutaneous PD catheters were successfully inserted in 37 of 44 patients (84.1%) after a median of 13.5 days (interquartile range [IQR] = 10.0, 20.3 days) in the ICU. No adverse events were reported; SOFA scores and ventilation requirements were comparable before and after insertion; and adequate RRT parameters were achieved. The median proportion of RRT provided by PD following catheter insertion was 94.6% (IQR = 75.0, 100%). Conclusion: Peritoneal dialysis provides a safe and effective alternative to CRRT in selected patients with AKI and COVID-19 infection requiring ventilation on intensive care. |
| first_indexed | 2024-12-14T23:22:26Z |
| format | Article |
| id | doaj.art-a33bb01cd1b24020b6f13b9ce6b13471 |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-14T23:22:26Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-a33bb01cd1b24020b6f13b9ce6b134712022-12-21T22:43:54ZengElsevierKidney International Reports2468-02492021-02-0162265271Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary CenterElaine Bowes0Jennifer Joslin1Dandisonba C.B. Braide-Azikiwe2Caroline Tulley3Kate Bramham4Sujit Saha5Satish Jayawardene6Babakang Shakoane7C. Jason Wilkins8Sam Hutchings9Philip Hopkins10Eirini Lioudaki11Catriona Shaw12Hugh Cairns13Claire C. Sharpe14King’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King’s College London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King’s College London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKFaculty of Life Sciences and Medicine, King’s College London, UK; Department of Critical Care, King’s College Hospital NHS Foundation Trust, London, UKDepartment of Critical Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UKKing’s Kidney Care, King’s College Hospital NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King’s College London, UK; Correspondence: Claire Sharpe, School of Immunology and Microbial Sciences, Department of Inflammation Biology, James Black Centre, Faculty of Life Sciences and Medicine, King’s College London, London, SE5 9NU, UK.Introduction: During the coronavirus disease 2019 (COVID-19) pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to an increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving challenging, and so alternatives to continuous renal replacement therapies (CRRT) in the intensive care unit (ICU) are needed. Peritoneal dialysis (PD) can be initiated immediately after percutaneous insertion of the catheter, but there are concerns about impact on ventilation and RRT efficacy. We sought to describe our recent experience with percutaneous catheter insertion and peritoneal dialysis in patients in the ICU with COVID-19 infection. Method: Patients were selected according to local protocol, and catheters were inserted percutaneously by experienced operators using a Seldinger technique. Sequential Organ Failure Assessment (SOFA) score and ventilation requirements were recorded at the time of insertion and 24 hours later. Procedural complications, proportion of RRT provided by PD, renal recovery, and RRT parameters (serum potassium and maximum base excess) during PD were assessed. Results: Percutaneous PD catheters were successfully inserted in 37 of 44 patients (84.1%) after a median of 13.5 days (interquartile range [IQR] = 10.0, 20.3 days) in the ICU. No adverse events were reported; SOFA scores and ventilation requirements were comparable before and after insertion; and adequate RRT parameters were achieved. The median proportion of RRT provided by PD following catheter insertion was 94.6% (IQR = 75.0, 100%). Conclusion: Peritoneal dialysis provides a safe and effective alternative to CRRT in selected patients with AKI and COVID-19 infection requiring ventilation on intensive care.http://www.sciencedirect.com/science/article/pii/S2468024920317952acute kidney injuryCOVID-19percutaneous catheter insertionperitoneal dialysis |
| spellingShingle | Elaine Bowes Jennifer Joslin Dandisonba C.B. Braide-Azikiwe Caroline Tulley Kate Bramham Sujit Saha Satish Jayawardene Babakang Shakoane C. Jason Wilkins Sam Hutchings Philip Hopkins Eirini Lioudaki Catriona Shaw Hugh Cairns Claire C. Sharpe Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center Kidney International Reports acute kidney injury COVID-19 percutaneous catheter insertion peritoneal dialysis |
| title | Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center |
| title_full | Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center |
| title_fullStr | Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center |
| title_full_unstemmed | Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center |
| title_short | Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19–Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center |
| title_sort | acute peritoneal dialysis with percutaneous catheter insertion for covid 19 associated acute kidney injury in intensive care experience from a uk tertiary center |
| topic | acute kidney injury COVID-19 percutaneous catheter insertion peritoneal dialysis |
| url | http://www.sciencedirect.com/science/article/pii/S2468024920317952 |
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