Abstract: FR-PO0524
Patterns of Peritoneal Dialysis Use for AKI in the United States: A Six-Year National Analysis
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
- He, Mingyue, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- Gillespie, Avrum, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- El Shamy, Osama, The George Washington University, Washington, District of Columbia, United States
- Hu, Susie L., Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background
Acute kidney injury (AKI) is a common complication in hospitalized patients, with significant morbidity and mortality. While peritoneal dialysis (PD) offers potential advantages for AKI management, its utilization patterns in the United States remain poorly characterized.
Methods
We conducted a retrospective cohort study analyzing National Inpatient Sample data from 2016-2021, identifying 1,540 patients who received PD for AKI. Patients were stratified by age (pediatric <18 years, n=925; adult ≥18 years, n=615). We examined utilization patterns, patient characteristics, and outcomes, with additional analysis comparing pre-pandemic (2016-2019) and pandemic (2020-2021) periods.
Results
PD represented a small fraction of all AKI-dialysis cases, with distinct utilization patterns between pediatric and adult populations. In-hospital mortality was similar between pediatric and adult patients (22.7% vs 22.0%, p=NS), despite pediatric patients having lower comorbidity burden. However, pediatric cases had significantly longer lengths of stay (51.5 vs 17.7 days) and higher hospital costs ($1,090,789 vs $311,289). We observed a 15.9% increase in overall PD utilization during the first year of the COVID-19 pandemic, particularly among adults, followed by subsequent decline.
Conclusion
While PD for AKI remains uncommon in the US, our findings demonstrate its feasibility across age groups with comparable mortality outcomes despite differences in resource utilization. The increased utilization during the pandemic highlights PD's potential role in health system crisis planning and an opportunity outside of crisis.
Funding
- Other NIH Support