Background: Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. Summary: The interest in PD to manage AKI patients has been increased and PD is now frequently used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be successfully treated using PD. Some of the classic limitations of PD use in AKI, such as infectious and mechanical complications and poor metabolic control, have been decreased with the use of cyclers, flexible catheters, and a high volume of dialysate. The recent publication of the International Society of Peritoneal Dialysis guidelines for PD in AKI has tried to address these issues and provide an evidence-based standard by which to initiate therapy. Key Message: In this review, advances in technical aspects and the advantages and limitations of PD were discussed; it clearly showed that PD is a simple, safe, and efficient way to correct metabolic, electrolyte, acid - base, and volume disturbances generated by AKI and it can be used as a renal replacement therapy modality to treat AKI, both in and out of the intensive care unit setting.

1.
Gaiao S, Finkelstein FO, de Cal M, Ronco C, Cruz DN: Acute kidney injury: are we biased against peritoneal dialysis? Perit Dial Int 2012;32:351-355.
2.
Kilonzo KG, Ghosh S, Temu SA, Maro V, Callegari J, Carter M, et al: Outcome of acute peritoneal dialysis in northern Tanzania. Perit Dial Int 2012;32:261-266.
3.
Gabriel DP, Caramori JT, Martim LC, Barretti P, Balbi AL: High volume peritoneal dialysis vs daily hemodialysis: a randomized, controlled trial in patients with acute kidney injury. Kidney Int Suppl 2008;73:S87-S93.
4.
Cullis B, Abdelraheem M, Abraham G, et al: Peritoneal Dialysis for Acute Kidney Injury. ISPD guidelines/recommendations. Perit Dial Int 2014;34:494-517.
5.
Rao P, Passadakis P, Oreopoulos DG: Peritoneal dialysis in patients with acute renal failure. Perit Dial Int 2003;23:320-322.
6.
Gabriel DP, Nascimento GV, Caramori JT, Martim LC, Barretti P, Balbi AL: Peritoneal dialysis in acute renal failure. Ren Fail 2006;28:451-456.
7.
Gabriel DP, Fernandez-Cean J, Balbi AL: Utilization of peritoneal dialysis in the acute setting. Perit Dial Int 2007;27:328-331.
8.
Finkelstein FO, Smoyer WE, Carter M, Brusselmans A, Feehally J: Peritoneal dialysis, acute kidney injury, and the Saving Young Lives program. Perit Dial Int 2014;34:478-480.
9.
Ash SR: Peritoneal dialysis in acute renal failure of adults: the under-utilized modality. Contrib Nephrol 2004;144:239-254.
10.
Ponce D, Banin VB, Bueloni TN, Barretti P, Caramori J, Balbi AL: Different outcomes of peritoneal catheter percutaneous placement by nephrologists using a trocar versus the Seldinger technique: the experience of two Brazilian centers. Int Urol Nephrol 2014;46:2029-2034.
11.
Passadakis PS, Oreopoulos DG: Peritoneal dialysis in patients with acute renal failure. Adv Perit Dial 2007;23:7-16.
12.
Chionh CY, Ronco C, Finkelstein FO, Soni SS, Cruz DN: Acute peritoneal dialysis: what is the ‘adequate' dose for acute kidney injury? Nephrol Dial Transplant 2010;25:3155-3160.
13.
Chionh CY, Soni S, Cruz DN, Ronco C: Peritoneal dialysis for acute kidney injury: techniques and dose. Contrib Nephrol 2009;163:278-284.
14.
Chitalia VC, Almeida AF, Rai H, Bapat M, Chitalia KV, Acharya VN, Khanna R: Is peritoneal dialysis adequate for hypercatabolic acute renal failure in developing countries? Kidney Int 2002;61:747-757.
15.
Gabriel DP, Nascimento GV, Caramori JT, Martim LC, Barretti P, Balbi AL: High volume peritoneal dialysis for acute renal failure. Perit Dial Int 2007;27:277-282.
16.
Ponce D, Berbel MN, Regina de Goes C, Almeida CT, Balbi AL: High-volume peritoneal dialysis in acute kidney injury: indications and limitations. Clin J Am Soc Nephrol 2012;7:887-894.
17.
Ponce D, Berbel MN, Abrão JM, Goes CR, Balbi AL; A randomized clinical trial of high volume peritoneal dialysis versus extended daily hemodialysis for acute kidney injury patients. Int Urol Nephrol 2013;45:869-878.
18.
Phu NH, Hien TT, Mai NT, Chau TT, Chuong LV, Loc PP, Winearls C, Farrar J, White N, Day N: Hemofiltration and peritoneal dialysis in infection-associated acute renal failure in Vietnam. N Engl J Med 2002;347:895-902.
19.
George J, Varma S, Kumar S, Thomas J, Gopi S, Pisharody R: Comparing continuous venovenous hemodiafiltration and peritoneal dialysis in critically ill patients with acute kidney injury: a pilot study. Perit Dial Int 2011;31:422-429.
20.
Ponce D, Berbel MN, Abrão JM, Goes CR, Balbi AL: A randomized clinical trial of high volume peritoneal dialysis versus extended daily hemodialysis for acute kidney injury patients. Int Urol Nephrol 2013;45:869-878.
21.
Al-Hweish A: Oral Communication Congress of Arab Society of Nephrology, 2014.
22.
Chionh CY, Soni SS, Finkelstein FO, Ronco C, Cruz DN: Use of peritoneal dialysis in AKI: a systematic review. Clin J Am Soc Nephrol 2013;8:1649-1660.
23.
Ponce D, Buffarah MB, Goes C, Balbi A: Peritoneal dialysis in acute kidney injury: trends in the outcome across time periods. PLoS One 2015;10:e0126436.
24.
Ponce D, Caramori JT, Barretti P, Balbi AL: Peritoneal dialysis in acute kidney injury: Brazilian experience. Perit Dial Int 2012;32:242-246.
25.
Miller FN, Hammerschmidt DE, Anderson GL, Moore JN: Protein loss induced by complement activation during peritoneal dialysis. Kidney Int 1984;25:480-485.
26.
Blumenkrantz MJ, Gahl GM, Kopple JD, Kamdar AV, Jones MR, Kessel M, Coburn JW: Protein losses during peritoneal dialysis. Kidney Int 1981;19:593-602.
27.
Bargman JM, Bick J, Cartier P, Dasgupta MK, Fine A, Lavoie SD, Spanner E, Taylor PA: Guidelines for adequacy and nutrition in peritoneal dialysis. Canadian Society of Nephrology. J Am Soc Nephrol 1999;10(suppl 13):S311-S321.
28.
Góes CR, Berbel MN, Balbi AL, Ponce D: Approach to the metabolic implications of peritoneal dialysis in acute kidney injury. Perit Dial Int 2015;35:397-405.
29.
Góes CR, Berbel MN, Balbi AL, Ponce D: Metabolic implications of peritoneal dialysis in patients with acute kidney injury. Perit Dial Int 2013;33:635-645.
30.
Vieira JM Jr, Castro I, Curvello-Neto A, Demarzo S, Caruso P, Pastore L Jr, Imanishe MH, Abdulkader RC, Deheinzelin D: Effect of acute kidney injury on weaning from mechanical ventilation in critically ill patients. Crit Care Med 2007;35:184-191.
31.
Epstein SW, Inouye T, Robson M, Oreopoulos DG: Effect of peritoneal dialysis fluid on ventilatory function. Perit Dial Bull 1982;2:120-122.
32.
Almeida CP, Ponce D, de Marchi AC, Balbi AL: Effect of peritoneal dialysis on respiratory mechanics in acute kidney injury patients. Perit Dial Int 2014;34:544-549.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.