The management of the patient with acute kidney injury (AKI) requires meticulous attention to fluid, acid-base, and electrolyte balance, as well as the removal of uremic toxins. Peritoneal dialysis (PD) is an overlooked procedure for dialytic support in AKI as it is primarily used for the treatment of patients with end-stage renal disease (ESRD). Nevertheless, acute PD remains a viable option for the treatment of selected patients with AKI, particularly those who are hemodynamically compromised or have severe coagulation abnormalities, or when other modalities are not readily available [1-3].
The advantages, indications, and contraindications of acute PD and the components of an acute PD prescription will be reviewed here. The indications for dialysis in acute renal failure (ARF) and the use of hemodialysis (HD) or continuous renal replacement therapies are discussed separately. (See "Renal replacement therapy (dialysis) in acute kidney injury (acute renal failure): Recovery of renal function and effect of hemodialysis membrane" and "Continuous renal replacement therapy in acute kidney injury (acute renal failure)".)
Compared with other available modalities, peritoneal dialysis (PD) has several advantages as a renal replacement therapy in patients with acute renal failure (ARF):
●It is widely available and technically easy to perform
●Large amounts of fluid can be removed in hemodynamically unstable patients; this fluid removal may also permit the administration of parenteral nutrition