Journal
KIDNEY INTERNATIONAL
Volume 100, Issue 1, Pages 2-5Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.kint.2021.04.017
Keywords
acute kidney injury; acute peritoneal dialysis; COVID-19; mortality; kidney replacement therapy
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Funding
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [K23 DK114476]
- NIDDK [R18 DK118471-01]
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The study demonstrated the feasibility of acute PD for acute kidney injury during the COVID-19 pandemic and identified male sex and mechanical ventilation on admission as significant predictors of mortality.
To demonstrate feasibility of acute peritoneal dialysis (PD) for acute kidney injury during the coronavirus disease 2019 (COVID-19) pandemic, we performed a multicenter, retrospective, observational study of 94 patients who received acute PD in New York City in the spring of 2020. Patient comorbidities, severity of disease, laboratory values, kidney replacement therapy, and patient outcomes were recorded. The mean age was 61 +/- 11 years; 34% were women; 94% had confirmed COVID-19; 32% required mechanical ventilation on admission. Compared to the levels prior to initiation of kidney replacement therapy, the mean serum potassium level decreased from 5.1 +/- 0.9 to 4.5 +/- 0.7 mEq/L on PD day 3 and 4.2 +/- 0.6 mEq/L on day 7 (P < 0.001 for both); mean serum bicarbonate increased from 20 +/- 4 to 21 +/- 4 mEq/L on PD day 3 (P [ 0.002) and 24 +/- 4 mEq/L on day 7 (P < 0.001). After a median follow-up of 30 days, 46% of patients died and 22% had renal recovery. Male sex and mechanical ventilation on admission were significant predictors of mortality. The rapid implementation of an acute PD program was feasible despite resource constraints and can be lifesaving during crises such as the COVID-19 pandemic.
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