Acute PD Lecture
Abstract List
Purpose
Acute kidney injury (AKI) remains a major challenge in critically ill patients, and the choice of kidney replacement therapy should be individualized according to patient characteristics and available resources. In recent years, acute peritoneal dialysis (PD) has re-emerged as an effective and practical modality for the management of AKI. This workshop aims to provide participants with an updated understanding of the role of acute PD in AKI, integrate current consensus recommendations with real-world clinical experience, and foster collaboration among nephrologists and critical care specialists across the Asia-Pacific region.
What Participants Will Learn
Participants will gain comprehensive knowledge of the indications, timing, and practical implementation of acute PD in patients with AKI. The program will cover the physiological principles of PD, prescription design, catheter insertion techniques, and the management of common complications, including ultrafiltration failure, metabolic acidosis, electrolyte disturbances, and peritonitis. Through case-based discussions and interactive simulation sessions, attendees will also develop practical skills in troubleshooting common ICU problems and integrating acute PD into multidisciplinary AKI programs. By the end of the workshop, participants will be equipped with both the theoretical foundation and hands-on experience necessary to incorporate acute PD into routine clinical practice.
Program Highlights
The workshop features a distinguished faculty of experts from leading medical centers who will share their insights and clinical experience in acute PD. The scientific program begins with an overview of the rationale, indications, and timing of acute PD in AKI, followed by practical discussions on initiating acute PD in the intensive care unit and case-based demonstrations. Additional sessions will address PD physiology, prescription strategies, catheter implantation techniques, and the management of common complications. Experts will also discuss strategies for incorporating acute PD into established AKI programs. The afternoon hands-on and simulation sessions provide participants with the opportunity to practice PD catheter insertion, refine prescription design and adjustment, and learn practical approaches to troubleshooting common ICU challenges, ensuring a comprehensive and clinically relevant learning experience.
| Time | Session |
|---|---|
|
08:00
08:10
|
Chih-Hsiang ChangTaiwan
Speaker
重塑生命韌性：從 ICU 治療到回歸社會的康復之路急性腎損傷的照護目標不應止於 ICU 存活或成功脫離連續性腎臟替代治療（CRRT），而應延伸至腎功能恢復、身體功能重建與重返家庭及社會。高品質 CRRT 是此一照護路徑的起點，包括適切的治療時機與劑量、血流動力學穩定、液體管理、抗凝策略及治療中斷監測，以降低治療相關傷害並提升腎臟恢復機會。然而，出院後追蹤中斷、急性腎損傷病程辨識不足及跨專業資訊斷裂，仍使患者面臨慢性腎臟病、長期透析、再住院及功能衰退的風險。因此，台灣應建立從 ICU 延伸至社區的急性腎損傷整合照護政策：以標準化品質指標確保 CRRT 治療品質；透過電子警示、風險分層與跨院資料串接辨識高風險患者；並於出院後整合腎臟功能、藥物、營養、復健及病人報告結果的追蹤。最終政策成效不僅應評估死亡率與透析依賴，更應納入腎功能恢復、再住院、生活品質及重返社會，將急性期救命治療轉化為可衡量、可持續的生命韌性照護。
|
|
08:10
08:50
|
|
|
08:50
09:30
|
|
|
09:30
10:10
|
Hsuan-Jen LinTaiwan
Speaker
Case-Based Demonstration and DiscussionPrescription Design and Adjustment Exercises (Case-based discussion)Troubleshooting Common ICU Problems (Case-based discussion)
|
|
10:10
10:30
|
|
|
10:30
11:10
|
Che-Yi ChouTaiwan
Speaker
Acute PD: Physiology, Prescription, and Technique (Surgical vs Percutaneous Implantation)Acute peritoneal dialysis (PD) is an effective, underutilized method for treating acute kidney injury through optimized, high-volume automated regimens. While percutaneous bedside insertion offers rapid, resource-efficient access for critically ill patients, surgical techniques provide better visualization and lower early leak rates.Prescription Design and Adjustment Exercises (Case-based discussion)This interactive, case-based discussion session focuses on the practical application of peritoneal dialysis (PD) prescription design and dynamic troubleshooting. Clinical practitioners often face challenges when translating standard PD guidelines into individualized patient care, particularly when balancing solute clearance, ultrafiltration goals, and patient lifestyle preferences. Utilizing a series of real-world patient scenarios, this session guides participants through the step-by-step process of calculating initial automated PD (APD) and continuous ambulatory PD (CAPD) prescriptions based on residual renal function and peritoneal membrane transport characteristics. Participants will actively analyze clinical data from cases demonstrating inadequate clearance, fluid overload, and metabolic complications. Through hands-on exercises, attendees will learn to systematically adjust dwell times, exchange volumes, and dextrose concentrations to optimize therapy. By the conclusion of this session, participants will possess the critical thinking skills necessary to confidently manipulate PD prescription variables, manage common prescription failures, and improve long-term patient outcomes.Troubleshooting Common ICU Problems (Case-based discussion) This interactive, case-based discussion session addresses the rapid identification and management of critical mechanical, metabolic, and infectious complications in the intensive care unit. Using realistic patient scenarios, clinicians will practice troubleshooting ventilator dyssynchrony, hemodynamic instability, continuous renal replacement therapy (CRRT) circuit alarms, and acute metabolic crises. Through hands-on exercises, participants will interpret real-time clinical data, isolate root causes, and execute immediate corrective interventions. This session equips multidisciplinary ICU teams with the critical thinking skills, diagnostic algorithms, and collaborative strategies necessary to resolve technical failures promptly and improve patient outcomes in high-stress environments.
|
|
11:10
11:50
|
Yu-Cyuan HongTaiwan
Speaker
Complication Management in Acute PD (UF Failure, Acidosis, Lytes, Peritonitis)Acute peritoneal dialysis remains a practical option for AKI when hemodynamic instability, coagulopathy, absent vascular access, or resource constraints limit extracorporeal therapy. Its complication profile, however, differs from that of chronic PD: the catheter is freshly placed, the membrane is acutely inflamed and often high-transport, exchanges are rapid and hypertonic.
First, inadequate ultrafiltration is separated into mechanical causes (catheter malposition, omental wrap, leak to pleural or subcutaneous tracking) and membrane-prescription causes. Management follows from that division — imaging and repositioning, or shortened dwell and adjusted tonicity — rather than reflexive escalation of dextrose concentration.
Electrolyte complications follow directly from the prescription: hypokalemia from potassium-free dialysate compounded by glucose-driven intracellular shift; hypernatremia from sodium sieving during short hypertonic dwells;
Peritonitis in acute PD differs from its chronic counterpart. Risk is front-loaded by bedside insertion, immediate use, and repeated manual exchanges, so prevention rests on closed connectology, cycling, and minimal manipulation. Short dwells dilute the effluent cell count, making neutrophil percentage more reliable than the absolute number; in a sedated septic patient the first sign may be falling ultrafiltration.
|
|
11:50
12:30
|
Chia-Lin WuTaiwan
Speaker
Integration of Acute PD into AKI ProgramsAcute kidney injury (AKI) affects 30–60% of critically ill patients, and dialysis-requiring AKI carries substantial short-term mortality and long-term risk of chronic kidney disease. While continuous renal replacement therapy and intermittent hemodialysis remain the default modalities in most high-income ICUs, acute peritoneal dialysis (PD) has re-emerged as a guideline-supported, outcome-comparable alternative—particularly valuable when vascular access, anticoagulation, or extracorporeal capacity are limited. The 2020 ISPD guideline update has standardized safe prescribing, and the COVID-19 pandemic demonstrated that acute PD programs can be stood up rapidly under pressure, with outcomes consistent with standard care. This presentation argues that the principal barriers to integrating acute PD into AKI programs are not clinical but organizational. Drawing on international literature and regional case experience, it presents a practical framework for building a program: catheter access and prescription fundamentals; a genuine nephrology–intensivist–nursing collaborative model with defined roles and governance; structured training pathways for catheter insertion and bedside nursing delivery, including simulation-based approaches used in low-resource settings; logistics planning for supply chains, staffing, and cost; and strategies for overcoming institutional barriers such as credentialing, reimbursement, and clinician culture.
|
|
12:30
12:40
|