Catheter Access Management for Acute Peritoneal Dialysis

Insertion of a peritoneal dialysis (PD) catheter is frequently done by interventional nephrologists, but these procedures are typically only performed for adults. Almost all invasive procedures in children are performed by pediatric surgeons. If a pediatric surgeon is unavailable, the initiation of PD in acute situations may be delayed, thus increasing the risk of complications and chronic kidney disease. For these patients, the main obstacle to initiating renal replacement therapy is access, even when involving central vein catheter (CVC) or peritoneal access. Here we report the case of a 10-kg baby affected by hemolytic and uremic syndrome diarrhea in whom all of the procedures to manage the complications of acute kidney injury (PD catheter insertion, PD catheter revision, CVC placement, and CVC revision) were undertaken by interventional nephrologists. This experience allowed us to rapidly treat the acute kidney injury, recover normal kidney function thereby avoiding chronic complications, and allowing us to discharge the baby from the intensive care unit.