Urgent vs. early-start peritoneal dialysis: patients' profile and outcomes

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Therapy

Background:

• Peritoneal dialysis (PD) is a recognized therapy for end-stage renal disease (ESRD).
• Urgent-Start PD (US-PD), initiated within 72 hours of catheter placement, and early-start PD (ES-PD), initiated between 3-14 days, are emerging concepts.
• Comparing outcomes between US-PD and ES-PD is crucial for optimizing dialysis initiation strategies.

Purpose of the Study:

• To compare demographic and clinical characteristics between US-PD and ES-PD patients.
• To evaluate 30-day complications, 6-month hospitalization rates, and dropout rates for both groups.
• To assess the safety and efficacy of initiating PD urgently.

Main Methods:

• Adult patients initiating PD within 14 days of catheter insertion were included.
• Patients were categorized into US-PD (≤72 hours) and ES-PD (>72 hours to 14 days) groups.
• Demographic data, fill volume, short-term complications, hospitalization, and dropout rates were analyzed.

Main Results:

• 72 patients were analyzed (40 US-PD, 32 ES-PD) with a mean age of 53.2 years.
• No significant differences were found in demographics, 30-day complications, 6-month hospitalizations, or dropout rates between US-PD and ES-PD.
• The most common short-term complication was leakage, and transfer to hemodialysis (HD) was the leading cause of dropout.

Conclusions:

• Fifty-five percent of patients initiated PD within 72 hours of catheter insertion.
• The comparable outcomes between US-PD and ES-PD encourage the use of urgent PD when clinically indicated.
• Urgent-Start PD is a viable option for patients requiring immediate dialysis initiation.