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Article: Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury.

Ponce, Daniela / Balbi, André L / Durand, Jonathan B / Moretta, Gustavo / Divino-Filho, José C

2020 Volume 13, Issue 3, Page(s) 269–273

Abstract: ... but surprisingly, acute kidney injury (AKI) may occur in 4-23% of cases, whereas the dialysis management of AKI ... The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2 ... Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years ...

Abstract	The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4-23% of cases, whereas the dialysis management of AKI from coronavirus 2019 has not gained much attention. The severity of the pandemic has resulted in significant shortages in medical supplies, including respirators, ventilators and personal protective equipment. Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years; however, it has been used on only a limited basis and therefore experience and knowledge of its use has gradually vanished, leaving a considerable gap. The turning point came in 2007, with a series of sequential publications providing solid evidence that PD is a viable option. As there was an availability constraint and a capacity limit of equipment/supplies in many countries, hemodialysis and convective therapies became alternatives. However, even these therapies are not available in many countries and their capacity is being pushed to the limit in many cities. Evidence-based PD experience lends support for the use of PD now.
Keywords	covid19
Language	English
Publishing date	2020-06-30
Publishing country	England
Document type	Editorial
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfaa102
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Article: Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury

Ponce, Daniela / Balbi, André L. / Durand, Jonathan B. / Moretta, Gustavo / Divino-Filho, José C.

Clinical Kidney Journal

Abstract: ... but surprisingly, acute kidney injury (AKI) may occur in 4–23% of cases, whereas the dialysis management of AKI ... The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2 ... Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years ...

Abstract	The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4–23% of cases, whereas the dialysis management of AKI from coronavirus 2019 has not gained much attention The severity of the pandemic has resulted in significant shortages in medical supplies, including respirators, ventilators and personal protective equipment Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years;however, it has been used on only a limited basis and therefore experience and knowledge of its use has gradually vanished, leaving a considerable gap The turning point came in 2007, with a series of sequential publications providing solid evidence that PD is a viable option As there was an availability constraint and a capacity limit of equipment/supplies in many countries, hemodialysis and convective therapies became alternatives However, even these therapies are not available in many countries and their capacity is being pushed to the limit in many cities Evidence-based PD experience lends support for the use of PD now
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #629113
Database	COVID19

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Article ; Online: Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury

Ponce, Daniela / Balbi, André L / Durand, Jonathan B / Moretta, Gustavo / Divino-Filho, José C

Clinical Kidney Journal ; ISSN 2048-8505 2048-8513

2020

Abstract: ... respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4–23% of cases, whereas the dialysis ... Abstract The kidney is not typically the main target of severe acute ... personal protective equipment. Peritoneal dialysis (PD) remains available and has been used in clinical practice ...

Abstract	Abstract The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4–23% of cases, whereas the dialysis management of AKI from coronavirus 2019 has not gained much attention. The severity of the pandemic has resulted in significant shortages in medical supplies, including respirators, ventilators and personal protective equipment. Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years; however, it has been used on only a limited basis and therefore experience and knowledge of its use has gradually vanished, leaving a considerable gap. The turning point came in 2007, with a series of sequential publications providing solid evidence that PD is a viable option. As there was an availability constraint and a capacity limit of equipment/supplies in many countries, hemodialysis and convective therapies became alternatives. However, even these therapies are not available in many countries and their capacity is being pushed to the limit in many cities. Evidence-based PD experience lends support for the use of PD now.
Keywords	Nephrology ; Transplantation ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/ckj/sfaa102
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Article: Advances in Peritoneal Dialysis in Acute Kidney Injury.

Ponce, Daniela / Zamoner, Welder / Dias, Dayana Bitencourt / Banin, Vanessa / Balbi, Andre Luis

Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion

2023 Volume 75, Issue 6, Page(s) 327–336

Abstract: Unassigned: In the 1970s, acute peritoneal dialysis (PD) was widely accepted for the treatment ... of acute kidney injury (AKI), but this practice has declined in favor of extracorporeal therapies, mainly in developed ... of advances to support PD treatment during AKI, discussing PD access, PD prescription, complications related ...

Abstract	Unassigned: In the 1970s, acute peritoneal dialysis (PD) was widely accepted for the treatment of acute kidney injury (AKI), but this practice has declined in favor of extracorporeal therapies, mainly in developed world. The lack of familiarity with the use of PD in critically ill patients has also led to a lack of use even among those receiving maintenance PD. Renewed interest in the use of PD for AKI therapy has emerged due to its increasing use in low- and middle-income countries due to its lower cost and minimal infrastructural requirements. In high-income countries, the coronavirus disease 2019 pandemic saw PD for AKI used early on, where many critical care units were in crisis and relied on PD use when resources for other AKI therapy modalities were limited. In this review, we highlight the advantages and disadvantages of PD in AKI patients and indications and contraindications for its use. We also provide an overview of advances to support PD treatment during AKI, discussing PD access, PD prescription, complications related to PD, and its use in particular clinical conditions. (Rev Invest Clin. 2023;75(6):327-36).
MeSH term(s)	Humans ; Peritoneal Dialysis/adverse effects ; Acute Kidney Injury/therapy ; COVID-19/complications ; COVID-19/therapy ; Critical Illness ; Intensive Care Units
Language	English
Publishing date	2023-12-28
Publishing country	Mexico
Document type	Review ; Journal Article
ZDB-ID	138348-6
ISSN	0034-8376
ISSN	0034-8376
DOI	10.24875/RIC.23000205
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Article ; Online: COVID-19 in ESRD and Acute Kidney Injury.

Kooman, Jeroen P / van der Sande, Frank M

Blood purification

2020 Volume 50, Issue 4-5, Page(s) 610–620

Abstract: ... patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity ... The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be ... associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct ...

Abstract	The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be at increased risk for infection due to viral transmission next to an enhanced risk for mortality as compared to the general population, even in the face of an often apparently mild clinical presentation. Derangements in the innate and adaptive immune systems may be responsible for a reduced antiviral response, whereas chronic activation of the innate immune system and endothelial dysfunction provide a background for a more severe course. The presence of severe comorbidity, older age, and a reduction of organ reserve may lead to a rapid deterioration of the clinical situation of the patients in case of severe infection. Secondly, patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity of the clinical disease. The presence of AKI, and especially the need for renal replacement therapy (RRT), is associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct viral invasion of kidney cells, activation of the renin-angiotensin aldosterone system, a hyperinflammatory response, hypercoagulability, and nonspecific factors such as hypotension and hypoxemia may be involved. Apart from logistic challenges and the need for strict hygiene within units, treatment of patients with ESRD and COVID-19 is not different from that of the general population. Extracorporeal treatment of patients with AKI with RRT can be complicated by frequent filter clotting due to the hypercoagulable state, for which regional citrate coagulation provides a reasonable solution. Also, acute peritoneal dialysis may be a reasonable option in these patients. Whether adjuncts to extracorporeal therapies, such as hemoadsorption, provide additional benefits in the case of severely ill COVID-19 patients needs to be addressed in controlled studies.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19/physiopathology ; COVID-19/transmission ; Comorbidity ; Cytokine Release Syndrome/etiology ; Cytokine Release Syndrome/prevention & control ; Disease Susceptibility ; Hemadsorption ; Humans ; Hygiene ; Immunocompromised Host ; Immunologic Factors/therapeutic use ; Infection Control ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/immunology ; Kidney Failure, Chronic/therapy ; Pandemics ; Renal Replacement Therapy ; Risk ; SARS-CoV-2 ; Thrombophilia/etiology ; Treatment Outcome
Chemical Substances	Immunologic Factors
Language	English
Publishing date	2020-12-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000513214
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Article ; Online: Management of acute kidney injury associated with Covid-19: what have we learned?

Cottam, Daniel / Nadim, Mitra K / Forni, Lui G

Current opinion in nephrology and hypertension

2021 Volume 30, Issue 6, Page(s) 563–570

Abstract: ... to both noncovid-related AKI and COVID-19 associated AKI. Kidney injury in COVID-19 associated AKI may arise ... Purpose of review: Although initially kidney involvement in COVID-19 infection was felt to occur ... multiorgan failure including acute kidney injury (AKI) is common and is associated with an increased risk ...

Abstract	Purpose of review: Although initially kidney involvement in COVID-19 infection was felt to occur relatively infrequently, this has proved not to be the case. In critically ill patients with COVID-19, multiorgan failure including acute kidney injury (AKI) is common and is associated with an increased risk of mortality and morbidity. This review focuses briefly on the epidemiology and pathophysiology of COVID-19 associated AKI as well as options for management. Recent findings: The risk factors for AKI are common to both noncovid-related AKI and COVID-19 associated AKI. Kidney injury in COVID-19 associated AKI may arise through several mechanisms, including not only direct effects on the kidney leading to tubular injury but also through the effects of treatment of multiorgan failure complicating infection. During surge conditions, the use of kidney replacement therapy has embraced all modalities including the use of peritoneal dialysis. The use of blood purification techniques has been proposed, but to date, the results are variable. Summary: COVID-19 associated AKI is common, affecting approximately a quarter of patients hospitalized with COVID-19. Glomerular injury can occur, but in the main tubular injury seems most likely leading to AKI, which should be managed following clinical pathways informed by accepted guidelines.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/therapy ; COVID-19 ; Critical Illness ; Humans ; Renal Replacement Therapy ; SARS-CoV-2
Language	English
Publishing date	2021-09-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1151092-4
ISSN	1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
ISSN (online)	1473-6543 ; 1535-3842
ISSN	1062-4813 ; 1062-4821
DOI	10.1097/MNH.0000000000000742
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Article: COVID-19 and the Kidney: A Worrisome Scenario of Acute and Chronic Consequences.

Sanchez-Russo, Luis / Billah, Marzuq / Chancay, Jorge / Hindi, Judy / Cravedi, Paolo

Journal of clinical medicine

2021 Volume 10, Issue 5

Abstract: Acute kidney injury (AKI) is a common finding in patients with coronavirus disease 2019 (COVID-19 ... and has been associated with higher rates of death when compared to COVID-19 patients without kidney ... injury. Whereas the definitive pathogenesis of COVID-19-related AKI (CoV-AKI) is not clear ...

Abstract	Acute kidney injury (AKI) is a common finding in patients with coronavirus disease 2019 (COVID-19) and has been associated with higher rates of death when compared to COVID-19 patients without kidney injury. Whereas the definitive pathogenesis of COVID-19-related AKI (CoV-AKI) is not clear, histopathologic evidence seems to point at multiple etiologies for the disease, including indirect and direct viral kidney injury. The high incidence of CoV-AKI, along with the aggressive clinical presentation of this entity, have increased the demands for kidney replacement therapies, rapidly overwhelming the supplies of healthcare systems even in major tertiary care centers. As a result, nephrologists have come up with alternatives to maximize the efficiency of treatments and have developed non-conventional therapeutic alternatives such as the implementation of acute peritoneal dialysis for critically ill patients. The long-term implications of CoV-AKI are yet unknown, though early studies suggest that around one third of the patients who survive will remain dependent on kidney replacement therapy. Nephrologists and healthcare workers need to be familiar with the clinical presentation and therapeutic challenges of CoV-AKI in order to develop strategies to mitigate the burden of the disease for patients, and for services providing kidney replacement therapies.
Language	English
Publishing date	2021-02-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10050900
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Article ; Online: Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care.

Deep, Akash / Bansal, Mehak / Ricci, Zaccaria

Blood purification

2020 Volume 50, Issue 2, Page(s) 150–160

Abstract: ... of acute kidney injury (AKI) in children affected by SARS-CoV-2. Dehydration seems to be the most common trigger factor ... and complications related to renal replacement therapy are the same for coronavirus disease (COVID ... modality of treatment. When to initiate and what modality to use are dependent on the available resources ...

Abstract	Children seem to be less severely affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) as compared to adults. Little is known about the prevalence and pathogenesis of acute kidney injury (AKI) in children affected by SARS-CoV-2. Dehydration seems to be the most common trigger factor, and meticulous attention to fluid status is imperative. The principles of initiation, prescription, and complications related to renal replacement therapy are the same for coronavirus disease (COVID) patients as for non-COVID patients. Continuous renal replacement therapy (CRRT) remains the most common modality of treatment. When to initiate and what modality to use are dependent on the available resources. Though children are less often and less severely affected, diversion of all hospital resources to manage the adult surge might lead to limited CRRT resources. We describe how these shortages might be mitigated. Where machines are limited, one CRRT machine can be used for multiple patients, providing a limited number of hours of CRRT per day. In this case, increased exchange rates can be used to compensate for the decreased duration of CRRT. If consumables are limited, lower doses of CRRT (15-20 mL/kg/h) for 24 h may be feasible. Hypercoagulability leading to frequent filter clotting is an important issue in these children. Increased doses of unfractionated heparin, combination of heparin and regional citrate anticoagulation, or combination of prostacyclin and heparin might be used. If infusion pumps to deliver anticoagulants are limited, the administration of low-molecular-weight heparin might be considered. Alternatively in children, acute peritoneal dialysis can successfully control both fluid and metabolic disturbances. Intermittent hemodialysis can also be used in patients who are hemodynamically stable. The keys to successfully managing pediatric AKI in a pandemic are flexible use of resources, good understanding of dialysis techniques, and teamwork.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/physiopathology ; Acute Kidney Injury/therapy ; Anticoagulants/therapeutic use ; COVID-19/epidemiology ; COVID-19/prevention & control ; Child ; Citrates/therapeutic use ; Comorbidity ; Continuous Renal Replacement Therapy/instrumentation ; Continuous Renal Replacement Therapy/methods ; Critical Care/methods ; Disease Management ; Disinfection ; Equipment Contamination/prevention & control ; Fluid Therapy ; Health Services Accessibility ; Hemodynamics ; Heparin/therapeutic use ; Humans ; Infection Control/methods ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Nephrology/organization & administration ; Patient Care Team ; Peritoneal Dialysis ; Prostaglandins I/therapeutic use ; Resource Allocation ; SARS-CoV-2 ; Time Factors
Chemical Substances	Anticoagulants ; Citrates ; Prostaglandins I ; Heparin (9005-49-6)
Keywords	covid19
Language	English
Publishing date	2020-07-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000509677
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Article: Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care

Deep, Akash / Bansal, Mehak / Ricci, Zaccaria

Blood Purif

Abstract	Children seem to be less severely affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) as compared to adults. Little is known about the prevalence and pathogenesis of acute kidney injury (AKI) in children affected by SARS-CoV-2. Dehydration seems to be the most common trigger factor, and meticulous attention to fluid status is imperative. The principles of initiation, prescription, and complications related to renal replacement therapy are the same for coronavirus disease (COVID) patients as for non-COVID patients. Continuous renal replacement therapy (CRRT) remains the most common modality of treatment. When to initiate and what modality to use are dependent on the available resources. Though children are less often and less severely affected, diversion of all hospital resources to manage the adult surge might lead to limited CRRT resources. We describe how these shortages might be mitigated. Where machines are limited, one CRRT machine can be used for multiple patients, providing a limited number of hours of CRRT per day. In this case, increased exchange rates can be used to compensate for the decreased duration of CRRT. If consumables are limited, lower doses of CRRT (15-20 mL/kg/h) for 24 h may be feasible. Hypercoagulability leading to frequent filter clotting is an important issue in these children. Increased doses of unfractionated heparin, combination of heparin and regional citrate anticoagulation, or combination of prostacyclin and heparin might be used. If infusion pumps to deliver anticoagulants are limited, the administration of low-molecular-weight heparin might be considered. Alternatively in children, acute peritoneal dialysis can successfully control both fluid and metabolic disturbances. Intermittent hemodialysis can also be used in patients who are hemodynamically stable. The keys to successfully managing pediatric AKI in a pandemic are flexible use of resources, good understanding of dialysis techniques, and teamwork.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #646291
Database	COVID19

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Article ; Online: COVID-19 and the Kidney

Luis Sanchez-Russo / Marzuq Billah / Jorge Chancay / Judy Hindi / Paolo Cravedi

Journal of Clinical Medicine, Vol 10, Iss 5, p

A Worrisome Scenario of Acute and Chronic Consequences

2021 Volume 900

Abstract	Acute kidney injury (AKI) is a common finding in patients with coronavirus disease 2019 (COVID-19) and has been associated with higher rates of death when compared to COVID-19 patients without kidney injury. Whereas the definitive pathogenesis of COVID-19-related AKI (CoV-AKI) is not clear, histopathologic evidence seems to point at multiple etiologies for the disease, including indirect and direct viral kidney injury. The high incidence of CoV-AKI, along with the aggressive clinical presentation of this entity, have increased the demands for kidney replacement therapies, rapidly overwhelming the supplies of healthcare systems even in major tertiary care centers. As a result, nephrologists have come up with alternatives to maximize the efficiency of treatments and have developed non-conventional therapeutic alternatives such as the implementation of acute peritoneal dialysis for critically ill patients. The long-term implications of CoV-AKI are yet unknown, though early studies suggest that around one third of the patients who survive will remain dependent on kidney replacement therapy. Nephrologists and healthcare workers need to be familiar with the clinical presentation and therapeutic challenges of CoV-AKI in order to develop strategies to mitigate the burden of the disease for patients, and for services providing kidney replacement therapies.
Keywords	AKI ; CKD ; COVID-19 ; CG ; CoV-AKI ; ATI ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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