Introduction:
Acute peritoneal dialysis (PD) is a feasible and relatively safe renal replacement therapy (RRT), commonly used in children with acute kidney injury (AKI). However, the choices of catheters, treatment regimens, and dosing remain unstandardized due to limited evidence. This review discusses the outcomes of acute PD using rigid stylet catheters, focusing on the frequency and types of complications encountered.
Methods:
This retrospective study examines the outcomes and challenges of acute PD with rigid stylet catheters in neonates, infants, and children over one year (June 2023 to June 2024) at a tertiary care center. The incidence of various complications and outcomes were analysed using SPSS version 28, with assistance from a statistician.
Results:
Rigid stylet catheters were used in 90 patients as a bedside procedure, including 52 (58%) paediatric patients, 24 (27%) infants, and 14 (15%) neonates. The mean duration of PD was 5 ± 2 days. Survival rates were 42% in neonates (6/14), 66% in infants (16/24), and 73% in paediatric patients (38/52). Complications included:
PD Leaks: Neonates (28%, n=4), infants (16%, n=4), children (9%, n=5)
Peritonitis: Neonates (21%, n=3), infants (16%, n=4), children (19%, n=10)
PD Blocks: Neonates (21%, n=3), infants (8%, n=2), children (23%, n=12)
There were no procedure-related deaths.
Conclusions:
In developing countries like India, preventable deaths from AKI are still prevalent. In resource-limited settings where continuous renal replacement therapy (CRRT) or automated peritoneal dialysis (APD) with Tenckhoff catheter is a costly affair and not feasible, rigid stylet catheters offer an affordable and practical solution for acute PD in emergencies. Despite its limitations, including the risk of peritonitis, it remains a safe and straightforward procedure for neonates, infants, and paediatric patients requiring RRT for less than a week. Refinement of this technique, such as using flexible catheters with the Seldinger technique, may further improve safety and acceptance.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.