CLINICAL CHARACTERISTICS AND OUTCOMES OF ACUTE INTERMITTENT PERITONEAL IN PATIENTS WITH ACUTE KIDNEY INJURY IN A TERTIARY CARE HOSPITAL- A FOUR YEAR RETROSPECTIVE STUDY

8 Feb 2025 12 a.m. 12 a.m.

WCN25-AB-3460, Poster Board= SAT-572

Introduction:

AKI occurs in 5.7 - 24% of ICU patients and is commonly associated with multiorgan failure, sepsis, renal hypoperfusion. AKI is independent predictor of mortality and there is higher need for renal replacement therapy in ICU patients. Two major types of RRT, Hemodialysis (HD) and peritoneal dialysis (PD) are available. PD is the first mode of dialysis used to treat AKI. With advent of CRRT in developed countries, use of PD started declining. But in resource poor settings, Acute Peritoneal dialysis remains as the important treatment modality for AKI in critically ill patients.

Methods:

STUDY DESIGN : Case record based retrospective Observation study

STUDY POPULATION : 1254 patients

STUDY DURATION : January 2021 to August 2024 (44 months)

INCLUSION CRITERIA : Patients admitted in medical ICU with AKI KDIGO stage 3 initiated on Acute Peritoneal dialysis were included in study.

Patient demographics, clinical characteristics, etiology of AKI, vasopressor use, mechanical ventilation were recorded. Biochemical and hematological parameters at the onset of RRT were noted.

AKI stage 3 was defined according to modified KIDIGO 2012 criteria as an increase in serum creatinine of 4 mg/dl or greater or an increase in >3.0 times from the reference value obtained at admission or the known baseline value or initiation of RRT.

RRT was received as Acute Peritoneal dialysis. A semirigid acute PD catheter placed by nephrologist bedside under local anesthesia. 1 liter 1.75% dextrose based PD solutions used and exchanges done manually with dwell of 45 minutes. PD prescription was individualized accordingly based on patient status, hemodynamic stability, volume status, lab parameters, ultrafiltration obtained and reviewed on daily basis.

Patients shifted to SLED/intermittent HD once they became hemodynamically stable.

Results:

Table 1. Clinico-demographic profile of the patients with AKI

Table 2. Lab profile of patients in our study

Table 3. Outcomes of peritoneal dialyis in patients with AKI in our study

Table 4. Comparison of demographic and clinical parameters among survivors and non-survivors

Table 5. Causes of Acute kidney injury among survivors and non-survivors

Conclusions:

Survival of patients on acute PD with AKI was 67.5%.

Septic shock (38.6%) followed by HIV (12.1%) was the most common indication for PD in our study

Risk factors like DM, HTN, lower albumin, severe metabolic acisosis, deranged LFT and hyperkalemia was associated with increased mortality.

Patients requiring ventilator support, shock at presentation requiring ionotrope support, MODS and higher qSOFA had higher mortality in our study.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.