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Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States.
Am J Kidney Dis. 2020 09; 76(3):401-406.AJ

Abstract

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.

Authors+Show Affiliations

Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. Electronic address: msourial@montefiore.org.Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.Montefiore-Einstein Center for Transplantation, Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY.Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32534129

Citation

Sourial, Maryanne Y., et al. "Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: a Single-Center Experience in a Time of Crisis in the United States." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 76, no. 3, 2020, pp. 401-406.
Sourial MY, Sourial MH, Dalsan R, et al. Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States. Am J Kidney Dis. 2020;76(3):401-406.
Sourial, M. Y., Sourial, M. H., Dalsan, R., Graham, J., Ross, M., Chen, W., & Golestaneh, L. (2020). Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 76(3), 401-406. https://doi.org/10.1053/j.ajkd.2020.06.001
Sourial MY, et al. Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: a Single-Center Experience in a Time of Crisis in the United States. Am J Kidney Dis. 2020;76(3):401-406. PubMed PMID: 32534129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: 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, Y1 - 2020/06/11/ PY - 2020/04/26/received PY - 2020/06/02/accepted PY - 2020/6/14/pubmed PY - 2020/9/2/medline PY - 2020/6/14/entrez 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 SP - 401 EP - 406 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 76 IS - 3 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. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/32534129/Urgent_Peritoneal_Dialysis_in_Patients_With_COVID_19_and_Acute_Kidney_Injury:_A_Single_Center_Experience_in_a_Time_of_Crisis_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(20)30735-6 DB - PRIME DP - Unbound Medicine ER -