Vascular access planning in peritoneal dialysis patients

Area of Science:

• Nephrology
• Vascular Surgery

Background:

• Peritoneal dialysis (PD) is a primary renal replacement therapy for end-stage renal disease.
• Annually, over 10% of PD patients transition to hemodialysis due to various reasons.
• Vascular access creation for this patient group is often suboptimal and lacks standardized guidelines.

Purpose of the Study:

• To review the current literature and guidelines on vascular access planning for PD patients.
• To identify the need for improved prediction of PD failure and proactive access creation.
• To propose a research agenda for optimizing vascular access in PD patients transitioning to hemodialysis.

Main Methods:

• Literature review of existing studies on vascular access in PD patients.
• Analysis of current clinical guidelines and recommendations.
• Discussion of challenges and future research directions.

Main Results:

• A significant percentage of PD patients require conversion to hemodialysis annually.
• Current guidelines lack specific criteria for identifying high-risk PD failure patients for preemptive vascular access.
• There is a paucity of recent literature addressing vascular access planning in this specific context.

Conclusions:

• Proactive vascular access planning is crucial for PD patients anticipating a switch to hemodialysis.
• Better patient selection criteria are needed to optimize the timing and type of vascular access creation.
• Further research is essential to develop evidence-based strategies for seamless transitions and improved patient outcomes.