Clinical practice guidelines for the provision of renal service in Hong Kong: Peritoneal Dialysis

Szeto, Cheuk Chun; Lo, Wai Kei; Li, Philip Kam-Tao

doi:10.1111/nep.13505

Cited by 5 publications

(6 citation statements)

References 93 publications

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“…Late referral and unforeseeable deterioration of residual renal function in known ESRD patients remain a major problem, which calls for unplanned-start PD or "crash start" in a shorter BI [13,14]. Several guidelines suggest that acute and urgent start of PD <2 weeks following catheter placement utilizes a recumbent, low-volume, intermittent dialysis regimen, thus leaving the peritoneal cavity dry during ambulatory periods to minimize the risk of leak [15][16][17]. Furthermore, Stegmayr [18] has reported that the 3 purse-string suture technique enables immediate start of PD with a low incidence of leakage.…”

Section: Introductionmentioning

confidence: 99%

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Yin

Cao

2020

Blood Purif

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Introduction: The best timing of peritoneal dialysis (PD) initiation after catheter implantation is still controversial. It is necessary to explore whether there exists a waiting period to minimize the risk of complications. Methods: A systematic review and meta-analysis were searched in multiple electronic databases published from inception to February 29, 2020, to identify cohort studies for evaluating the outcome and safety of unplanned-start PD (<14 days after catheter insertion). Risks of bias across studies were evaluated using Newcastle-Ottawa Quality Assessment Scale. Results: Fourteen cohort studies with a total of 2,401 patients were enrolled. We found that early-start PD was associated with higher prevalence of leaks (RR: 2.67, 95% CI, 1.55–4.61) and omental wrap (RR: 3.28, 95% CI, 1.14–9.39). Furthermore, patients of unplanned-start PD in APD group have higher risk of leaks, while those in CAPD group have a higher risk of leaks, omental wrap, and catheter malposition. In shorter break-in period (BI) group, the risk of suffering from catheter obstruction and malposition was higher for patients who started dialysis within 7 days after the surgery than for patients within 7–14 days. No significant differences were found in peritonitis (RR: 1.00; 95% CI, 0.78–1.27) and exit-site infections (RR: 1.12; 95% CI, 0.72–1.75). However, shorter BI was associated with higher risk of mortality and transition to hemodialysis (HD) while worsen early technical survival, with pooled RR of 2.14 (95% CI, 1.52–3.02), 1.42 (95% CI, 1.09–1.85) and 0.95 (95% CI, 0.92–0.99), respectively. Conclusions: Evidence suggests that patients receiving unplanned-start PD may have higher risks of mechanical complications, transition to HD, and even mortality rate while worsening early technical survival, which may not be associated with infectious complications. Rigorous studies are required to be performed.

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Section: Introductionmentioning

confidence: 99%

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Yin

Cao

2020

Blood Purif

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“…(2016) and Szeto et al. (2019) researches, which revealed the key factor in the control of infection was the locations where dialysate exchanges are performed, such as ideally a clean, private and enclosed space. Mudge et al.…”

Section: Discussionmentioning

confidence: 99%

“…Dialysate exchanges may even be done in a car or tour bus, but the vehicle engine must be switched off, the vehicle should be parked at a safe spot, and the air conditioning system and windows must be shut off to create a non‐ventilated space to prevent infection (Lu & Lin, 2018; Mudge et al., 2016). Such flexibility in the selection of the dialysis settings also provides PD patients with greater autonomy and independence (Kazancioglu, 2013; Szeto et al., 2019).…”

Section: Discussionmentioning

confidence: 99%

Developing a theory to help guide End‐Stage Renal Disease Patients to adapt to Peritoneal Dialysis: A grounded theory study

Chen

Yao

Tseng

et al. 2021

Journal of Clinical Nursing

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Aim and objectives:The aim of this study was to develop a theory to help guide patients with end-stage renal disease to adapt to peritoneal dialysis.Background: Taiwan ranks first worldwide in end-stage renal disease incidence and dialysis prevalence. Many patients cannot accept long-term dialysis treatment and thus face several physical and psychological suffering. No theory has yet been developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis.Design: A grounded theory approach was used in this study. Methods:A theoretical sampling was performed after interviewing 25 patients who had adapted to peritoneal dialysis at a medical centre in Taiwan from January 2018 to September 2018; data saturation was achieved. Data were analysed using open, axial and selective coding and while using the constant comparison technique. COREQ reporting guidelines were utilised.Results: A substantive theory was developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis. The core category that emerged from the data collected was 'Confronting peritoneal dialysis to live and co-exist with peritoneal dialysis'. Other key categories linked to and embraced in this core category were as follows: positive self-regulation, regulation of daily life and the process of adaptation to dialysis method. Conclusion:The results could help healthcare professionals to better understand the process of end-stage renal disease patients' adaptation to peritoneal dialysis, thereby facilitating patients' adaptation to dialysis in their daily life, enhancing their quality of life and improving the quality of medical care.Relevance to clinical practice: Healthcare professionals could use this theory as reference when providing care for peritoneal dialysis patients to assist them in adapting to life with peritoneal dialysis as soon as possible through positive self-regulation, daily life adjustments and the process of adapting to the dialysis method.

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“…The provision of adequate dialysis could mitigate uremia-associated anorexia and might improve hypercatabolism. If Kt/V urea is borderline (1.78 in the present case), consideration should be given to increasing the PD dose or the number of CAPD bag exchanges and assessing prescription adherence (National Kidney Foundation, 2006; Szeto et al, 2019). However, in the present case, the dialysis nurse opined that a further increase in the dose/number of CAPD bag exchanges could have compromised the patient’s quality of life and led to a transfer to hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Kt/V urea is a consistent predictor of survival in PD patients (Canada-USA (CANUSA) Peritoneal Dialysis Study Group, 1996) and is, therefore, an important monitoring parameter. The total (peritoneal and kidney) small-solute clearance should be a total Kt/V urea of ≥1.7 per week (Szeto et al, 2019). The peritoneal equilibration test (PET) classified the patient as an average transporter (4 h dialysate to plasma ratio of creatinine [D/P creatinine], 0.791; 4 to 0 h dialysate glucose ratio [D/D0 glucose], 0.334).…”

Section: Case Presentationmentioning

confidence: 99%

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

Yip

2021

SAGE Open Nursing

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Introduction Peritonitis remains the primary cause of treatment failure among patients with end-stage kidney disease on continuous ambulatory peritoneal dialysis. However, detailed case analyses illustrating the application of current research in clinical practice remain scant. This case report aimed to elucidate the roles of dialysis nurses in a hospital setting in the management of a 62-year-old male patient with a history of kidney failure secondary to amyloidosis. Case Presentation The patient was diagnosed with continuous ambulatory peritoneal dialysis-associated peritonitis. Management and Outcomes Dialysis nurses applied evidence-based practices in the management of the patient’s exit-site infection, imbalanced nutrition, and psychosocial concerns. The patient was discharged after 7 days, with a comprehensive treatment regimen, including an individualized peritoneal dialysis protocol adjusted to his daily schedules, education on self-care techniques, and continual nutritional management to prevent recurrence and improve his overall health. This case report shows that admissions for continuous ambulatory peritoneal dialysis-associated peritonitis require evidence-based nursing interventions specific to, and geared toward, each patient’s prioritized health problems. Discussion Peritonitis cases are preventable with appropriate nursing interventions that can lower the chance of treatment failure and long-term impact caused by an abrupt switch to hemodialysis. To successfully manage patients with continuous ambulatory peritoneal dialysis-associated peritonitis, dialysis nurses should appreciate the intricacies of the analyses underpinning their professional practices in promoting the patient’s self-care techniques.

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Clinical practice guidelines for the provision of renal service in Hong Kong: Peritoneal Dialysis

Cited by 5 publications

References 93 publications

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Developing a theory to help guide End‐Stage Renal Disease Patients to adapt to Peritoneal Dialysis: A grounded theory study

Peritoneal Dialysis Failure and its Impact on Holistic Kidney Care: A Case Report

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