Acute kidney injury (AKI) is a heterogeneous syndrome with multiple etiologies. It occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. In this scenario, AKI alters the kidney-brain axis, exposing patients who receive habitual dialytic management to greater injury. Various therapies have been designed to mitigate this risk. Priority has been placed by KDIGO guidelines on the use of continuous over intermittent acute kidney replacement therapies (AKRT). On this background, continuous therapies have a pathophysiological rationale in patients with acute brain injury. A low-efficiency therapy such as PD and CRRT could achieve optimal clearance control and potentially reduce the risk of secondary brain injury. Therefore, this work will review the evidence on peritoneal dialysis as a continuous AKRT in neurocritical patients, describing its benefits and risks so it may be considered as an option when deciding among available therapeutic options.
Keyphrases
- brain injury
- end stage renal disease
- peritoneal dialysis
- chronic kidney disease
- subarachnoid hemorrhage
- acute kidney injury
- cerebral ischemia
- intensive care unit
- ejection fraction
- newly diagnosed
- liver failure
- cardiac surgery
- prognostic factors
- multiple sclerosis
- drug induced
- respiratory failure
- clinical practice
- case report
- blood brain barrier
- high intensity
- mesenchymal stem cells
- cell therapy
- mechanical ventilation
- extracorporeal membrane oxygenation