POS-106 CONTINUOUS AMBULATORY PERITONEAL DIALYSIS FOR ACUTE KIDNEY INJURY

Abstract

Continuous ambulatory peritoneal dialysis is a modality used for Renal replacement in patients with End stage renal disease. Herein we report a patient who developed recurrent cardiac arrest with hemodialysis, and hence CAPD was done to treat her Acute Kidney Injury (AKI). A 55 year old woman presented with complaints of pedal edema, progressive dyspnea from last 1 month, with reduced urine output from last 2 days. Known case of diabetic nephropathy since 1 year, with baseline creatinine of 3.2 mg/dl. History of native medication use for one week. She was suspected to have worsening CKD due to native medicines with a serum creatinine of 10.2 mg/dl, and planned for hemodialysis. She was started on hemodialysis and developed cardiac arrest within half hour of initiation, and further developed seizures within half hour of starting second session, and another episode of cardiac arrest within ten minutes of starting third session despite change of dialyzers and heparin. A possibility of dialyzer reaction was considered and she was planned for continuous ambulatory peritoneal dialysis for her AKI. She underwent bedside insertion of Swan neck Tenckhoff catheter and initiated on CAPD, with 3 exchanges per day and discharged home after 4 days. After two weeks, she developed gradual recovery of renal function and became dialysis independent with creatinine of 4.4 mg/dl. CAPD has rarely been used as a modality for treatment of dialysis for AKI. We report a case of successful use of CAPD for AKI in a patient with repeated cardiac arrests. CAPD can therefore be used with good outcomes in resource limited settings.