Safety and Feasibility of Early Initiation of Peritoneal Dialysis at a Safety-Net Hospital

IntroductionTraditionally peritoneal dialysis (PD) is initiated >3 weeks post-placement for tract maturation. The pandemic spurred a need for earlier initiation. We hypothesized that there is no significant difference between outcomes of early start (<2 weeks) vs standard (>2 weeks).MethodsA retrospective review was conducted between 2020 to 2022 at a safety-net hospital and included patients who received a PD catheter ("PDC"). Demographics, technique, dialysate volume, and outcomes were analyzed.Results83 patients met criteria. 47/83 (56.6%) were male, the average age was 49.9 [41-60] years, and average BMI was 30.7 [26-34.6]. Average dialysate volume was 2.13 L (±1.31). There were no significant differences in readmissions, reoperations, or catheter issues between the two groups. Patients with higher BMI and catheter-related issues were more likely to be readmitted (P = 0.0003) and undergo reoperation (P = 0.0021).ConclusionsEarly initiation of PD was not associated with significant differences in complications compared to standard start. Our study demonstrates the feasibility and safety of early PD initiation.