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Use of peritoneal dialysis for the treatment of acute kidney injury in adults

Thomas A Golper, MD
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD


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 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 peritoneal dialysis 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 [1-6].

The advantages, indications, and contraindications of acute peritoneal dialysis and the components of an acute peritoneal dialysis prescription will be reviewed here. The indications for dialysis in AKI and the use of hemodialysis or continuous renal replacement therapies are discussed separately. (See "Dialysis-related factors that may influence recovery of renal function in acute kidney injury (acute renal failure)" and "Continuous renal replacement therapy in acute kidney injury (acute renal failure)".)


Compared with other available modalities, peritoneal dialysis has several advantages as a renal replacement therapy in patients with AKI:

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.

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Literature review current through: Nov 2017. | This topic last updated: Sep 25, 2017.
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