Related Experiment Video
Updated: May 28, 2026
06:23
Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
Published on: May 23, 2025
Urgent-start peritoneal dialysis: a quality improvement report
1Division of Nephrology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. ghaffari@usc.edu
Summary
Urgent-start peritoneal dialysis (PD) is a safe and feasible option for patients with end-stage renal disease needing immediate dialysis. This structured program demonstrates comparable short-term outcomes to non-urgent PD, supporting wider adoption.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Quality Improvement
Background:
- Peritoneal dialysis (PD) is underutilized in the US despite being cost-effective and patient-centered.
- Nephrologists' unfamiliarity with urgent PD initiation contributes to its underuse.
- Patients with end-stage renal disease often require urgent dialysis without a pre-existing modality plan.
Purpose of the Study:
- To assess the safety and feasibility of an urgent-start PD program.
- To compare short-term clinical outcomes and complications of urgent-start PD versus non-urgent PD.
- To provide a framework for establishing similar urgent-start PD programs.
Main Methods:
- A quality improvement report detailing a single-center study.
- 18 patients with urgent need for dialysis initiated on PD.
- Comparison with 9 non-urgently started PD patients, analyzing 90-day outcomes and complications.
Main Results:
- Short-term clinical outcomes were similar between urgent-start and non-urgent-start PD groups.
- Uncorrected serum calcium was lower in the urgent-start group (P=0.02).
- Complication rates were similar, with a higher incidence of minor leaks in the urgent-start group.
Conclusions:
- A structured urgent-start PD program is safe and feasible for patients requiring immediate dialysis.
- The program's framework can guide the development of local urgent-start PD initiatives.
- Further studies with larger sample sizes may be beneficial.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
01:30Peritoneal Dialysis I: Introduction and Procedure
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
01:25Peritoneal Dialysis III: Nursing Management
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:25Hemodialysis I: Introduction
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...