Automated Peritoneal Dialysis Versus Intermittent Hemodialysis in Acute Kidney Injury

Launched by LIMENG CHEN · Jul 15, 2018

Keywords

ClinConnect Summary

The incidence of acute kidney injury (AKI) is rapidly increasing worldwide. This is a common and devastating disorder, especially in critical illnesses, affecting 5-8% of all hospitalized patients and up to 30% of those in intensive care units, with high mortality. About 50-80% critical patients with AKI needed dialysis treatment. Intermittent hemodialysis (IHD) might be the most-commonly modalities applied in AKI patients requiring dialysis. However, no data of randomized study concerning renal recovery and treatment efficiency of AKI patients treated with APD is available in Chinese adult...

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Eligibility criteria

• Inclusion Criteria:
• • AKI patients according to Acute Kidney Injury Network criteria
• • Rapidly rising serum creatinine level (a sudden increase of at least 30%)
• • Meeting the indications for dialysis
• • Uremia or azotemia (BUN\>80 mg/dl)
• • Fluid overload (after diuretics use)
• • Electrolyte imbalance (K\>5.5 mEq/L after clinical treatment)
• • Acid-base disturbance (pH\<7.2 and bicarbonate\<10mEq/L after clinical treatment)
• Exclusion Criteria:
• • Age under 18 years, or older than 80 years
• • Urinary tract obstruction; acute interstitial nephritis or rapidly progressive glomerulonephritis needed immunoinhibitory therapy
• • Previously received renal replacement therapy(RRT) of any type/presence of dialysis access during the current illness.
• • Pre-existing severe chronic kidney disease (baseline serum creatinine\>4mg/dl) more than 10 days prior to initiation of first RRT.
• • Absolute contraindication of peritoneal dialysis such as recent abdominal surgery (\<1month), multiple abdominal surgeries.
• • Absolute contraindication for hemodialysis such as hemodynamic instability (systolic blood pressure \<80mmHg).
• • Pregnant.