Peritoneal Dialysis in Austere Environments: An Emergent Approach to Renal Failure Management

• Type of Material: Article
• Authors: Steven Gorbatkin, Emory University; John Bass, Madigan Army Medical Center; Fredic O. Finkelstein, Yale University
• Language: English
• Date: 2018-05-01
• Publisher: eScholarship Publishing, University of California
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Gorbatkin et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5811/westjem.2018.3.36762
• Title of Journal or Parent Work: Western Journal of Emergency Medicine
• ISSN: 1936-900X
• Volume: 19
• Issue: 3
• Start Page: 548
• End Page: 556
• Research Categories: Health Sciences, General; Health Sciences, Medicine and Surgery

Abstract

Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available lifesaving measure for acute kidney injury (AKI) or ESRD. PD in austere environments is not without challenges, including catheter placement, availability of dialysate, and medical complications related to the procedure itself. However, when hemodialysis is unavailable, PD can be performed using generally available medical supplies including sterile tubing and intravenous fluids. Amidst the ever-increasing global burden of ESRD and AKI, the ability to perform PD is essential for many medical facilities.