Use of Peritoneal Dialysis for Acute Kidney Injury during the COVID-19 Pandemic in New York City: A multicenter observational study

Chen, Wei; Caplin, Nina; El Shamy, Osama; Sharma, Shuchita; Sourial, Maryanne Y.; Ross, Michael J.; Sourial, Mina H.; Prudhvi, Kalyan; Golestaneh, Ladan; Srivatana, Vesh; Dalsan, Rochelle; Shimonov, Daniil; Sanchez-Russo, Luis; Atallah, Sara; Uribarri, Jaime

To demonstrate feasibility of acute peritoneal dialysis (PD) for acute kidney injury during the coronavirus disease 2019 (COVID-19) pandemic, we performed a multicenter, retrospective, observational study of 94 patients who received acute PD in New York City in the Spring of 2020. Patient comorbidities, severity of disease, laboratory values, kidney replacement therapy (KRT), and patient outcomes were recorded. Mean age was 61±11 years; 34% were women; 94% had confirmed COVID-19; 32% required mechanical ventilation on admission. Compared to the levels prior to initiation of KRT, mean serum potassium decreased from 5.1±0.9 to 4.5±0.7 on PD Day 3 and 4.2±0.6 mEq/L on Day 7 (p<0.001 for both); mean serum bicarbonate increased from 20±4 to 21±4 on PD Day 3 (p=0.002) and 24±4 mEq/L on Day 7 (p<0.001). After a median follow up of 30 days, 46% patients died and 22% had renal recovery. Male sex and mechanical ventilation on admission were significant predictors of mortality. The rapid implementation of an acute PD program was feasible despite resource constraints and can be lifesaving during crises such as the COVID-19 pandemic.