Integration of Acute PD into AKI Programs
18 Sep 2026
11:50
12:30
Chia-Lin Wu
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.