Peritoneal dialysis for COVID-19-associated acute kidney injury
Mika Nagatomo, Hiroyuki Yamada, Ken Shinozuka, Manabu Shimoto, Tomoyuki Yunoki, Shigeru Ohtsuru
Abstract
Dear Editor,Coronavirus disease 2019 (COVID-19) is rapidly spreading all over the world.One of the reasons for this quick spread is that the virus may be transmitted via aerosolize particles from asymptomatic individuals.To avoid further transmission, a huge amount of personal protective equipment (PPE) and specialized medical equipment is necessary.As the pandemic evolves, the shortage of these resources has become one of the biggest social problems worldwide.Thus, we are forced to provide appropriate treatments with limited available resources.Acute kidney injury (AKI) is also one of the significant complications of COVID-19, along with respiratory failure [1].Recent retrospective studies have shown that COVID-19 patients who develop acute kidney injury (AKI) have an extremely poor prognosis [2-4].To rescue these severe patients, renal replacement therapy (RRT) should definitely be considered.However, in terms of infection control and medical resources, it is much more challenging to perform hemodialysis than before the pandemic happened.Herein, using an actual case, we argue that peritoneal dialysis (PD) could become a more practical and safer RRT, particularly during this pandemic crisis.A 62-year-old male with a PCR test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) developed dyspnea.After admission to the depressurized room in our intensive care unit (ICU), his oxygenation and hemodynamics rapidly deteriorated.We started mechanical ventilation and administered vasopressors