Peritoneal dialysis in acute kidney injury: Your questions answered

Abstract

In acute kidney injury, no dialytic method has been shown to be superior in terms of mortality or recovery of kidney function. Peritoneal dialysis is an excellent treatment option, since it is continuous and can be adapted to clinical needs, it offers hemodynamic stability, adequate solute clearance, correction of electrolyte and acidosis disorders, appropriate ultrafiltration in volume overload, it is cheaper, does not require anticoagulation, provides calories, can be performed at the patient's bedside, its prescription is simple and does not require such sophisticated machinery. And when compared with other modalities, it has been shown to be equally efficient and safe, although its use is limited, partly due to the lack of knowledge and experience with this modality. Existing clinical evidence has consistently shown that this modality has very similar results in terms of the most relevant objectives evaluated in AKI. This modality offers certain advantages in specific contexts of acute kidney injury, such as cardiorenal syndrome, hepatorenal syndrome, in unstable patients on vasopressors, and in neurocritical patients. For all these reasons, we believe that peritoneal dialysis in acute kidney injury has sufficient arguments to be implemented more frequently and receive the value it deserves.