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Kidney Week

Abstract: PO0669

Renal Recovery in COVID-19 with AKI Managed on Peritoneal Dialysis

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Varma, Elly, Weill Cornell Medicine, New York, New York, United States
  • Shankaranarayanan, Divya, Weill Cornell Medicine, New York, New York, United States
  • Neupane, Sanjay P., Weill Cornell Medicine, New York, New York, United States
  • Shimonov, Daniil, Weill Cornell Medicine, New York, New York, United States
  • Gerardine, Supriya, Weill Cornell Medicine, New York, New York, United States
  • Lamba, Perola, Weill Cornell Medicine, New York, New York, United States
  • Leuprecht, Lorenz, Weill Cornell Medicine, New York, New York, United States
  • Salinas, Thalia, Weill Cornell Medicine, New York, New York, United States
  • Bhasin, Aarti, Weill Cornell Medicine, New York, New York, United States
  • Srivatana, Vesh, Weill Cornell Medicine, New York, New York, United States
Background

Acute peritoneal dialysis (AKI-PD) used to manage about 20% of our COVID-19 AKI patients requiring renal replacement therapy (RRT) of whom 45% had renal recovery.

Methods

Retrospective chart review of 11 consecutive patients undegoing bedside PD catheter placement from 4/1/2020 to 4/30/2020

Results

Median time from admission to the development of AKI was 1 day (IQR 0-3) (Table 1). In 73% of the patients, CRRT or intermittent HD was used as the initial RRT modality; CRRT circuit clotting was the primary reason for switching to PD in 2 patients. Median time from diagnosis of AKI to PD catheter insertion was 5 days (IQR 2-14). At one week, 10 catheters (91%) were functional with no leaks or bleeding detected. Only one patient was switched to CRRT due to primary PD catheter non-function; this patient had BMI greater than 35 kg/m2 and a history of appendectomy. Median duration of follow up from time of PD catheter placement was 37 days (IQR 32-37.5), death-censored median follow up was 35 days (IQR 30-37.5). The median time from AKI to death was 17 days (IQR 14-22). Median time from AKI to renal recovery was 34 days (IQR 21- 40).

Conclusion

In our AKI-PD cohort, the mortality rate was noted to be 36% and 45% had renal recovery during the follow up period. We hypothesize that preservation of residual renal function utilizing PD may have contributed to the high rate of renal recovery observed.Two of our patients converted from CRRT to PD due to repeated filter clotting. We did not observe any bleeding complications in our cohort. We hypothesize that hypercoagulable COVID-19 patients may be excellent candidates for PD potentially due to lower risk of bleeding complications.