Risks of Death in Acute Peritoneal Dialysis for Acute Kidney Injury
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Abstract
Background: Acute peritoneal dialysis (PD) is one of the treatments of choice for acute kidney injury (AKI) patients especially in the hemodynamically unstable patients and has high mortality rate. However, the large outcome series and risk factors of death of acute PD in AKI have never been documented. Methods: Retrospective cohort of 167 AKI patients who had required acute peritoneal dialysis at the tertiary care hospital in Thailand were reviewed. Baseline characteristic data, clinical outcomes at 90th day after acute PD were collected and analyzed to find the risk factors of death. Results: Nightly-four acute PD patients were analyzed. Mean age of patients was 56 years. Mortality rate at 90th day of acute PD patients was 67%. Risks of death were unstable hemodynamic state (HR =13.21, 1.37-127.07) and respiratory failure (HR=4.32, 1.34-53.5) at start of acute PD, BUN <50 mg/dl (HR =1.58, 1.04-5.66) or Cr <4 mg/dl (HR =4.24, 1.08-36.8) at start of dialysis. However age, diabetes and hypoalbuminemia were not associated with increased death in acute PD patients. Conclusion: The most important risk factor of death in acute PD patients was unstable hemodynamic state at start of dialysis. Besides the aspect of dialysis, maintenance of hemodynamic state was also the important issue in AKI patients.
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