TY - JOUR
T1 - Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury
T2 - A Single-Center Experience in a Time of Crisis in the United States
AU - Sourial, Maryanne Y.
AU - Sourial, Mina H.
AU - Dalsan, Rochelle
AU - Graham, Jay
AU - Ross, Michael
AU - Chen, Wei
AU - Golestaneh, Ladan
N1 - Publisher Copyright:
© 2020
PY - 2020/9
Y1 - 2020/9
N2 - At Montefiore Medical Center in The Bronx, NY, the first case of coronavirus disease 2019 (COVID-19) was admitted on March 11, 2020. At the height of the pandemic, there were 855 patients with COVID-19 admitted on April 13, 2020. Due to high demand for dialysis and shortages of staff and supplies, we started an urgent peritoneal dialysis (PD) program. From April 1 to April 22, a total of 30 patients were started on PD. Of those 30 patients, 14 died during their hospitalization, 8 were discharged, and 8 were still hospitalized as of May 14, 2020. Although the PD program was successful in its ability to provide much-needed kidney replacement therapy when hemodialysis was not available, challenges to delivering adequate PD dosage included difficulties providing nurse training and availability of supplies. Providing adequate clearance and ultrafiltration for patients in intensive care units was especially difficult due to the high prevalence of a hypercatabolic state, volume overload, and prone positioning. PD was more easily performed in non–critically ill patients outside the intensive care unit. Despite these challenges, we demonstrate that urgent PD is a feasible alternative to hemodialysis in situations with critical resource shortages.
AB - At Montefiore Medical Center in The Bronx, NY, the first case of coronavirus disease 2019 (COVID-19) was admitted on March 11, 2020. At the height of the pandemic, there were 855 patients with COVID-19 admitted on April 13, 2020. Due to high demand for dialysis and shortages of staff and supplies, we started an urgent peritoneal dialysis (PD) program. From April 1 to April 22, a total of 30 patients were started on PD. Of those 30 patients, 14 died during their hospitalization, 8 were discharged, and 8 were still hospitalized as of May 14, 2020. Although the PD program was successful in its ability to provide much-needed kidney replacement therapy when hemodialysis was not available, challenges to delivering adequate PD dosage included difficulties providing nurse training and availability of supplies. Providing adequate clearance and ultrafiltration for patients in intensive care units was especially difficult due to the high prevalence of a hypercatabolic state, volume overload, and prone positioning. PD was more easily performed in non–critically ill patients outside the intensive care unit. Despite these challenges, we demonstrate that urgent PD is a feasible alternative to hemodialysis in situations with critical resource shortages.
KW - COVID nephropathy
KW - COVID-19
KW - acute care
KW - acute kidney injury (AKI)
KW - acute renal failure (ARF)
KW - continuous renal replacement therapy (CRRT)
KW - coronavirus
KW - dialysis
KW - intensive care unit (ICU)
KW - peritoneal dialysis (PD)
KW - resource allocation
KW - resource shortage
KW - urgent-start PD
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U2 - 10.1053/j.ajkd.2020.06.001
DO - 10.1053/j.ajkd.2020.06.001
M3 - Article
C2 - 32534129
AN - SCOPUS:85087216497
SN - 0272-6386
VL - 76
SP - 401
EP - 406
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 3
ER -