TY - JOUR
T1 - Management of peritoneal dialysis in an adolescent with septic shock, AKI, multi-organ failure and COVID-19
T2 - a case report
AU - Andiantoro, Dirgo Suseno
AU - Sedono, Rudyanto
AU - Jennefer, Jennefer
N1 - Funding Information:
This article was presented at the 7th International Conference and Exhibition on Indonesian Medical Education and Research Institute (7th ICE on IMERI), Faculty of Medicine, Universitas Indonesia. We appreciate the exceptional support of the 7th ICE on the IMERI committee during the manuscript preparation and peer-review process.
Publisher Copyright:
© 2023 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - The kidneys is the most commonly injured organs in sepsis, which might manifest as acute kidney injury (AKI). Peritoneal dialysis (PD) is the preferred modality of renal replacement therapy (RRT), especially in the developing countries. Furthermore, the COVID-19 pandemic has made hemodialysis (HD) unavailable due to infection concerns. We present a critically-ill 16-year-old male with morbid obesity (BMI 43.3 kg/m2), diabetic ketoacidosis, acute pancreatitis, acute kidney injury, and COVID-19 pneumonia. The patient looked somnolent on admission with very high random blood glucose and hypernatremia. Blood gas analysis showed metabolic acidosis. The patient was treated with 1 g/day Meropenem, 0.5 µg/kg/min norepinephrine, 0.04 unit/kg/h vasopressin, and correction of electrolyte imbalance and metabolic acidosis. After 48 h, the diuresis and the creatinine levels worsened. We placed a Tenckhoff catheter and started PD. The patient showed improvement after 72 h of peritoneal dialysis. This case report highlighted the use of PD as a modality of RRT in sepsis-induced AKI, multi-organ failure, and COVID-19. Although it remains controversial, we observed an improvement in diuresis and creatinine levels following PD. PD is more cost-effective and provides a similar outcome compared to other modalities. Abbreviations: AKI - Acute Kidney Injury; BMI- Body Mass Index; CRRT- Continous Renal Replacement Therapu; GCS-Glasgow Coma Scale; HD- Hemodialysis; ICU- Intensive Care Unit; PD- Peritoenal Dialysis; RRT- Renal Replacement Therapy; S-AKI- Sepsis-Associated Acute Kidney Injury; SIRS- Systemic Inflammatory Response Syndrome.
AB - The kidneys is the most commonly injured organs in sepsis, which might manifest as acute kidney injury (AKI). Peritoneal dialysis (PD) is the preferred modality of renal replacement therapy (RRT), especially in the developing countries. Furthermore, the COVID-19 pandemic has made hemodialysis (HD) unavailable due to infection concerns. We present a critically-ill 16-year-old male with morbid obesity (BMI 43.3 kg/m2), diabetic ketoacidosis, acute pancreatitis, acute kidney injury, and COVID-19 pneumonia. The patient looked somnolent on admission with very high random blood glucose and hypernatremia. Blood gas analysis showed metabolic acidosis. The patient was treated with 1 g/day Meropenem, 0.5 µg/kg/min norepinephrine, 0.04 unit/kg/h vasopressin, and correction of electrolyte imbalance and metabolic acidosis. After 48 h, the diuresis and the creatinine levels worsened. We placed a Tenckhoff catheter and started PD. The patient showed improvement after 72 h of peritoneal dialysis. This case report highlighted the use of PD as a modality of RRT in sepsis-induced AKI, multi-organ failure, and COVID-19. Although it remains controversial, we observed an improvement in diuresis and creatinine levels following PD. PD is more cost-effective and provides a similar outcome compared to other modalities. Abbreviations: AKI - Acute Kidney Injury; BMI- Body Mass Index; CRRT- Continous Renal Replacement Therapu; GCS-Glasgow Coma Scale; HD- Hemodialysis; ICU- Intensive Care Unit; PD- Peritoenal Dialysis; RRT- Renal Replacement Therapy; S-AKI- Sepsis-Associated Acute Kidney Injury; SIRS- Systemic Inflammatory Response Syndrome.
KW - Acute kidney injury
KW - Peritoneal dialysis
KW - Septic shock
UR - http://www.scopus.com/inward/record.url?scp=85167800684&partnerID=8YFLogxK
U2 - 10.35975/apic.v27i4.2163
DO - 10.35975/apic.v27i4.2163
M3 - Article
AN - SCOPUS:85167800684
SN - 1607-8322
VL - 27
SP - 600
EP - 603
JO - Anaesthesia, Pain and Intensive Care
JF - Anaesthesia, Pain and Intensive Care
IS - 4
ER -