OUTCOME OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN PATIENT WITH ACUTE KIDNEY INJURY

Dr. Md. Tanvir Rahman*, Dr. K. B. M. Hadiuzzaman, Dr. Towhida Noor, Dr. G. M. Hafizur Rahman,
Dr. Hossain Muhammad  Mustafijur Rahman, Dr. Amrit K. C.6, Dr. Al Asma ul Taslima7, Dr. Faruque Ahmed8, Dr. Nahid Afrin9 and Dr. Golam Mahabub Sikder10

ABSTRACT

Introduction: Though peritoneal dialysis has several limitations, it is still used in acute kidney injury (AKI) patients as an alternative method of renal replacement therapy (RRT) especially in low socioeconomic countries. Materials and method: This prospective observational study included thirty patients diagnosed as AKI fulfilling the indication for initiation of dialysis. Peritoneal access was established through flexible Tenckhoff catheter for continuous ambulatory peritoneal dialysis (CAPD) and 6-8 exchanges were done in 24 hours. Results: Among 30 patients in this study mean age was (mean±SD) 49.93±14.42 years, seven (23.33%) patients were hemodynamically unstable. The cause of AKI was drug induced in 6(20.7%), hypovolemia/ATN in 6(20.0%), sepsis in 5(16.7%), heart failure in 2(6.7%) and 11(36.7%) had multiple causes. In initial presentation mean serum creatinine was 683.42 μmol/L, and the number of session required for stabilization of serum creatinine were 7.5±1.43, sessions required for correction of hyperkalemia and metabolic acidosis were 2.15±0.69 and 2.5±0.76 respectively. The delivered Kt/V urea was 1.95±0.14 weekly. Six (20.0%) patients had peritonitis, five (16.7%) had peri catheter leakage. Among 30 patients, three patients (10%) had died, sixteen (59.3%) had recovery of renal function and rest did not recover renal function. Conclusion: CAPD was effective for correction of metabolic and electrolyte imbalance leading to adequate and gradual reduction of serum creatinine within an acceptable time limit with favorable outcome and minimal complications.

Keywords: Acute kidney injury, continuous ambulatory peritoneal dialysis, Tenckhoff catheter.