Peritoneal dialysis in the treatment of focal segmental glomerulosclerosis patients with acute kidney injury

Objective:To observe the efficacy and safety of peritoneal dialysis(PD) in the treatment of focal segmental glomerulosclerosis(FSGS) patients with acute kidney injury(AKI).Methodology:Nineteen FSGS patients with AKI were enrolled in this study.They were received DAPD with a daily exchange of 1 ~ 8L for at least 3 months.The clinical efficacy,peritoneal dialysis related complications,and biochemical parameters were reviewed.Results:The patients had a mean follow-up of more than 3 months.The mean time of PD treatment was(5.0±2.9) months(range 2 to 10 months).10(52.7%) of the 19 cases had a normal renal function,9 cases got rid of dialysis,and one switched to hemodialysis therapy.More than 70% of patients had satisfying volume and blood pressure control.At the end of follow-up,the levels of serum creatinine was decreased to 65.6% of baseline(P0.05) and BUN was decreased to 47.9% of baseline(P0.01).The patients also had increased serum albumin,pre-albumin and urine output,and decreased proteinuria,urine NAG and RBP.Edema usually subsided within 4 weeks of PD therapy and the mean time of renal function recovery was(3.7±1.6) months(range 1 to 6 months).The PD-related complications occurred in 8 cases(42.0%),including 5 peritonitis,1 catheter exit site infection,one poor dialysate drainage and one dialysate leakage to the thoracic cavity.No clinically significant complications such as perivascular effusion and abdominal organ damage were noted.The peritoneal protein losses in 24 hours were 0.73 g/L.Conclusion:Due to its efficacy and less adverse events,short-term PD can be used as an effective auxiliary treatment for nephrotic syndrome(NS) with AKI,especially for those who presented with severe edema and massive ascites,and for those who had poor response to diuretics.