Outcomes of PD for AKI treatment during COVID-19 in New York City : A multicenter study
BACKGROUND: The high incidence of acute kidney injury (AKI) requiring dialysis associated with COVID-19 led to the use of peritoneal dialysis (PD) for the treatment of AKI. This study aims to compare in-hospital all-cause mortality and kidney recovery between patients with AKI who received acute PD versus extracorporeal dialysis (intermittent haemodialysis and continuous kidney replacement therapy).
METHODS: In a retrospective observational study of 259 patients with AKI requiring dialysis during the COVID-19 surge during Spring 2020 in New York City, we compared 30-day all-cause mortality and kidney recovery between 93 patients who received acute PD at any time point and 166 patients who only received extracorporeal dialysis. Kaplan-Meier curves, log-rank test and Cox regression were used to compare survival and logistic regression was used to compare kidney recovery.
RESULTS: The mean age was 61 ± 11 years; 31% were women; 96% had confirmed COVID-19 with median follow-up of 21 days. After adjusting for demographics, comorbidities, oxygenation and laboratory values prior to starting dialysis, the use of PD was associated with a lower mortality rate compared to extracorporeal dialysis with a hazard ratio of 0.48 (95% confidence interval: 0.27-0.82, p = 0.008). At discharge or on day 30 of hospitalisation, there was no association between dialysis modality and kidney recovery (p = 0.48).
CONCLUSIONS: The use of PD for the treatment of AKI was not associated with worse clinical outcomes when compared to extracorporeal dialysis during the height of the COVID-19 pandemic in New York City. Given the inherent selection biases and residual confounding in our observational study, research with a larger cohort of patients in a more controlled setting is needed to confirm our findings.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis - 43(2023), 1 vom: 01. Jan., Seite 13-22 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sourial, Maryanne Y [VerfasserIn] |
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| Links: |
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| Themen: |
Acute kidney injury |
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| Anmerkungen: |
Date Completed 18.01.2023 Date Revised 02.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/08968608221130559 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM348341741 |
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| 100 | 1 | |a Sourial, Maryanne Y |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of PD for AKI treatment during COVID-19 in New York City |b A multicenter study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The high incidence of acute kidney injury (AKI) requiring dialysis associated with COVID-19 led to the use of peritoneal dialysis (PD) for the treatment of AKI. This study aims to compare in-hospital all-cause mortality and kidney recovery between patients with AKI who received acute PD versus extracorporeal dialysis (intermittent haemodialysis and continuous kidney replacement therapy) | ||
| 520 | |a METHODS: In a retrospective observational study of 259 patients with AKI requiring dialysis during the COVID-19 surge during Spring 2020 in New York City, we compared 30-day all-cause mortality and kidney recovery between 93 patients who received acute PD at any time point and 166 patients who only received extracorporeal dialysis. Kaplan-Meier curves, log-rank test and Cox regression were used to compare survival and logistic regression was used to compare kidney recovery | ||
| 520 | |a RESULTS: The mean age was 61 ± 11 years; 31% were women; 96% had confirmed COVID-19 with median follow-up of 21 days. After adjusting for demographics, comorbidities, oxygenation and laboratory values prior to starting dialysis, the use of PD was associated with a lower mortality rate compared to extracorporeal dialysis with a hazard ratio of 0.48 (95% confidence interval: 0.27-0.82, p = 0.008). At discharge or on day 30 of hospitalisation, there was no association between dialysis modality and kidney recovery (p = 0.48) | ||
| 520 | |a CONCLUSIONS: The use of PD for the treatment of AKI was not associated with worse clinical outcomes when compared to extracorporeal dialysis during the height of the COVID-19 pandemic in New York City. Given the inherent selection biases and residual confounding in our observational study, research with a larger cohort of patients in a more controlled setting is needed to confirm our findings | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute kidney injury | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a continuous kidney replacement therapy | |
| 650 | 4 | |a haemodialysis | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a peritoneal dialysis | |
| 700 | 1 | |a Gone, Anirudh |e verfasserin |4 aut | |
| 700 | 1 | |a Uribarri, Jaime |e verfasserin |4 aut | |
| 700 | 1 | |a Srivatana, Vesh |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Shuchita |e verfasserin |4 aut | |
| 700 | 1 | |a Shimonov, Daniil |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Mowrey, Wenzhu |e verfasserin |4 aut | |
| 700 | 1 | |a Dalsan, Rochelle |e verfasserin |4 aut | |
| 700 | 1 | |a Sedaliu, Kaltrina |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Swati |e verfasserin |4 aut | |
| 700 | 1 | |a Ross, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Caplin, Nina |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Wei |e verfasserin |4 aut | |
| 700 | 0 | |a New York City Peritoneal Dialysis Consortium |e verfasserin |4 aut | |
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