The majority of patients receiving peritoneal dialysis have end-stage kidney disease (ESKD). However, according to Nicholas Seidler, MD, and colleagues, current data on peritoneal dialysis in patients with critical illness focus on utilization of the modality in patients with acute kidney injury. The researchers conducted a study designed to examine the mortality and temporal trends for patients receiving peritoneal dialysis in the setting of critical illness.
Results of the retrospective cohort study were reported during a poster session at the National Kidney Foundation Spring Clinical Meetings 2023. The poster was titled Outcomes in Critical Care Admissions in Peritoneal Dialysis Patients.
The study cohort included adult patients with ESKD receiving peritoneal dialysis who were admitted to an intensive care unit (ICU) at Rhode Island Hospital, Providence, and Miriam Hospital, Providence, between January 1, 2015, and January 1, 2022. Data on dialysis modalities used in the ICU, admission outcomes, and 1-year outcomes were collected.
The analysis included 67 critical care admissions among 45 patients. Fifty-two percent were female, and mean age was 54 years. During the ICU admission, 64% received peritoneal dialysis, 6% received hemodialysis, 9% received peritoneal dialysis and hemodialysis, and 16% received peritoneal dialysis, hemodialysis, and continuous renal replacement therapy.
Of those patients receiving peritoneal dialysis at discharge, 48% remained on peritoneal dialysis at 1 year postdischarge, 21% had transitioned to hemodialysis, and 21% had died. Of those discharged on hemodialysis, 90% remained on hemodialysis at 1 year, none had transitioned back to peritoneal dialysis, and 10% had died.
In summary, the researchers said, “Most patients received peritoneal dialysis while in the ICU, and the second largest group began with peritoneal dialysis but was transitioned to hemodialysis. Of those discharged on peritoneal dialysis, less than half remained on peritoneal dialysis after 1 year. Of those discharged on hemodialysis, none transitioned back to peritoneal dialysis after 1 year.”
Source: Seidler N, Chatragadda B, Raker C, Hu S, Shah A. Outcomes in critical care admissions in peritoneal dialysis patients. Poster #367. Abstract of a poster presented at the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas.