Acute PD in AKI: Why, When, and How?

  Acute kidney injury (AKI) remains a major challenge worldwide, particularly among critically ill and hemodynamically unstable patients requiring kidney replacement therapy. Although extracorporeal therapies are commonly utilized, peritoneal dialysis (PD) is increasingly recognized as an effective, safe, and underutilized option for AKI management. Recent ISPD guidelines support acute PD as a suitable renal replacement modality across diverse clinical settings, with outcomes comparable to extracorporeal therapies in selected patients.

  This presentation will review the rationale, indications, and practical implementation of acute PD in AKI, focusing on the questions of “Why, When, and How?”. We will discuss patient selection, timing of initiation, and PD prescription strategies, as well as catheter insertion techniques performed by nephrologists and surgeons under local anesthesia. In addition, we will highlight Taiwan’s experience with automated peritoneal dialysis (APD) and remote patient management using ShareSource, demonstrating how digital technologies can facilitate acute PD delivery and monitoring. Through international evidence and real-world experience, this session aims to provide clinicians with practical insights into integrating acute PD into modern AKI care.