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Using manual exchanges for an urgent-start peritoneal dialysis program.

Mihran V Naljayan1, Farshid Yazdi1, Efrain Reisin1

  • 1Department of Medicine, Section of Nephrology and Hypertension, Louisiana State University School of Medicine, New Orleans, LA, USA.

Clinical Kidney Journal
|October 6, 2018
PubMed
Summary
This summary is machine-generated.

Manual exchanges are a viable option for urgent-start peritoneal dialysis (USPD), showing low rates of peritonitis and infection. This approach offers patient mobility and aids in monitoring dialysis effectiveness.

Keywords:
ESRDcyclermanual exchangesperitoneal dialysisurgent start

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Peritoneal Dialysis

Background:

  • Urgent-start peritoneal dialysis (USPD) typically uses automated peritoneal dialysis (APD).
  • Manual exchanges have not been previously reported for USPD.
  • This study investigated manual exchanges as an alternative for USPD initiation.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of manual exchanges in USPD.
  • To compare the rates of peritonitis, exit-site infection (ESI), pericatheter leaks, and PD discontinuation with historical APD data.

Main Methods:

  • Retrospective study of 20 patients initiating PD via a USPD protocol (May 2014 - August 2016).
  • Initial dwell volumes were 750-1000 mL for 2-3 exchanges/day over 7 days, then doubled.
  • Patients received furosemide 160 mg twice daily.

Main Results:

  • Low complication rates were observed: 5% peritonitis, 0% ESI, 5% pericatheter leak, and 5% discontinuation.
  • These outcomes are comparable to those typically seen with APD in USPD.

Conclusions:

  • Manual exchange is a viable modality for urgent-start peritoneal dialysis.
  • This method enhances patient mobility and allows for direct monitoring of ultrafiltration and effluent.
  • Manual exchanges can facilitate patient training and engagement in their dialysis regimen.