PD vs. IHD in AKI
Trial question
Is lower-dosage acute peritoneal dialysis superior to intermittent hemodialysis in patients with AKI?
Study design
Multi-center
Open label
RCT
Population
157 patients.
Inclusion criteria: patients with AKI.
Key exclusion criteria: age < 18 years; CKD stage 5; HIV; severe hypercatabolism.
Interventions
N=80 acute lower-dosage peritoneal dialysis (18-24 L/day).
N=77 intermittent hemodialysis (thrice weekly).
Primary outcome
Death at day 28
50%
49.4%
50.0 %
37.5 %
25.0 %
12.5 %
0.0 %
Acute lower-dosage peritoneal
dialysis
Intermittent
hemodialysis
No significant
difference ↔
No significant difference in death at day 28 (50% vs. 49.4%; RD 0.6, 95% CI -15 to 16.3).
Secondary outcomes
No significant difference in dialysis-free survival at day 28 (41.8% vs. 37.1%; RD 4.6, 95% CI -11.1 to 20.3).
Borderline significant decrease in fluid balance at day 7 (3018 ,018 mL vs. 3200 ,018 mL; AD -182 ,018 mL, 95% CI -364.31 to 0.31).
Conclusion
In patients with AKI, acute lower-dosage peritoneal dialysis was not superior to intermittent hemodialysis with respect to death at day 28.
Reference
Watanyu Parapiboon, Sajja Tatiyanupanwong, Kamol Khositrangsikun et al. Lower-Dosage Acute Peritoneal Dialysis versus Acute Intermittent Hemodialysis in Acute Kidney Injury: A Randomized Controlled Trial. Clin J Am Soc Nephrol. 2024 Aug 1;19(8):970-977.
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