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Urgent-Start Peritoneal Dialysis: The First Year of Brazilian Experience

Dayana Bitencourt Dias1, Marcela Lara Mendes, Vanessa Burgugi Banin

  • 1São Paulo State University - UNESP, Alameda dasHortencias, Botucatu, Brazil.

Blood Purification
|October 25, 2017
PubMed

Insights

Urgent-start peritoneal dialysis (PD) is a safe and feasible option for patients needing immediate dialysis. This study found low complication rates and good patient survival within the first six months.

Area of Science:

  • Nephrology
  • Renal Medicine

Background:

  • Urgent-start dialysis is crucial for end-stage renal disease (ESRD) patients.
  • Peritoneal dialysis (PD) offers an alternative to hemodialysis for immediate initiation.

Purpose of the Study:

  • To assess mechanical and infectious complications of urgent-start PD.
  • To evaluate patient and technique survival in the initial 180 days of PD.

Main Methods:

  • Prospective study of chronic patients starting unplanned PD within 72 hours of catheter placement.
  • Utilized high-volume PD (HVPD) initially, followed by intermittent PD post-discharge.
  • Included 51 patients with ESRD, primarily due to diabetes and uremia.

Main Results:

  • Achieved metabolic and fluid control after 3 HVPD sessions.
  • Mechanical complications occurred in 25.7%; peritonitis rate was 0.5 episodes/patient-year.
  • Six-month patient and technique survival rates were 82.4% and 86%, respectively.

Conclusions:

  • Urgent-start PD is a viable and safe alternative to urgent hemodialysis.
  • Effective for rapid initiation of renal replacement therapy in critical situations.
Abstract

Keywords:
Acute peritoneal dialysisUnplanned peritoneal dialysisUrgent-start dialysisUrgent-start peritoneal dialysis

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