Impact of Break-In Period on the Short-Term Outcomes of Patients Started on Peritoneal Dialysis

Liu, Yaorong; Zhang, Lin; Lin, Aiwu; Ni, Zhaohui; Qian, Jiaqi; Fang, Wei

doi:10.3747/pdi.2012.00293

Cited by 58 publications

(85 citation statements)

References 26 publications

(53 reference statements)

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“…This has recently been confirmed in a much larger Chinese study (9) including 657 patients divided into 3 groups according to the length of the break-in period (≤ 7 days, 8 -14 days, and > 14 days) between catheter implantation and initiation of PD. They reported that the group with a break-in period ≤ 7 days had a statistically significantly higher incidence of mechanical complications compared with the group with a break-in period > 14 days during the first 6 months of PD.…”

Section: Complicationsmentioning

confidence: 56%

Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

Povlsen

Ivarsen

2015

Perit Dial Int

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Unplanned start on dialysis remains a major problem for the dialysis community worldwide. Late-referred patients with end-stage renal disease (ESRD) and urgent need for dialysis are overrepresented among older people. These patients are particularly likely to be started on in-center hemodialysis (HD), with a temporary vascular access known to be associated with excess mortality and increased risks of potentially lethal complications such as bacteremia and central venous thrombosis or stenosis.The present paper describes in detail our program for unplanned start on automated peritoneal dialysis (APD) right after PD catheter implantation and summarizes our experiences with the program so far. Compared with planned start on PD after at least 2 weeks of break-in between PD catheter implantation and initiation of dialysis, unplanned start may be associated with a slight increased risk of mechanical complications but apparently no detrimental effect on mortality, peritonitis-free survival, or PD technique survival.In our opinion and experience, the risk of serious complications associated with the implantation and immediate use of a PD catheter is less than the risk of complications associated with unplanned start on HD with a temporary central venous catheter (CVC). Unplanned start on APD is a gentle, safe, and feasible alternative to unplanned start on HD with a temporary CVC that is also valid for the latereferred older patient with ESRD and urgent need for dialysis. Perit Dial Int

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Section: Complicationsmentioning

confidence: 56%

Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

Povlsen

Ivarsen

2015

Perit Dial Int

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“…Ivarsen and Povlsen [1], Povlsen et al [8] and Liu et al [16] showed that total mechanical complications occurred significantly more in urgent-start than conventional start PD [1,8,16]. They noted that there was an increased need for surgical replacement of PD catheter in the urgent group.…”

Section: Discussionmentioning

confidence: 99%

“…Seven previous studies assessed the risk of catheter dysfunction in urgent-start PD [1,4,5,6,7,10,16] and the rate of risk ranged from 1.9 to 33.3%. These studies also assessed the rate of PD-related infections.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Background: This study aimed to evaluate mechanical and infectious complications associated with urgent-start peritoneal dialysis (PD) and patients and technique survival in the first 180 days. Methods: It was a prospective study that evaluated chronic patients who started unplanned PD using high-volume PD (HVPD) right after (<72 h) PD catheter placement. After hospital discharge, patients were treated with intermittent PD on alternate days in a dialysis unit until family training was provided. Results: Fifty-one patients fulfilling the following criteria were included: age was 62.1 ± 15 years, with diabetes as the main etiology of end-stage renal disease (39%), and uremia as the main dialysis indication (76%). Metabolic and fluid controls were achieved after 3 sessions of HVPD, and patients remained in intermittent PD for 23.2 ± 7.2 days. Mechanical complications occurred in 25.7% and peritonitis rate was 0.5 episode/patient-year. In the first 6 months, technique and patients survival rates were 86 and 82.4% respectively. Conclusion: The PD modality was a feasible and safe alternative to hemodialysis in the urgent-start dialysis.

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“…A previous large, retrospective study at this center including 657 ESRD patients, of whom 136 (20.7%) had diabetes, found that a break-in period of < 1 week might be related to a minor increased risk of mechanical complications but had no major effect on technique survival in PD patients [21]. Another previous large, retrospective study (n = 178, including 51 diabetics) in our center reported that urgent-start PD resulted in fewer short-term dialysis-related complications, fewer dialysis-related complications requiring re-insertion, and less bacteremia compared with urgent-start HD, with no significant difference in patient survival [22].…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus

Jin¹,

Ni²,

Che³

et al. 2018

Blood Purif

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Aims: This study aimed to compare the short-term complications and long-term prognosis between urgent-start peritoneal dialysis (PD) and hemodialysis (HD), and explore the safety and feasibility of PD in end-stage renal disease (ESRD) patients with diabetes. Methods: This retrospective study enrolled ESRD patients with diabetes who required urgent-start dialysis at a single center from January 2011 to December 2014. Short-term (30-day) dialysis-related complications and patient survival trends were compared between patients receiving PD and HD. Results: Eighty patients were included in the study, including 50 (62.5%) who underwent PD. The incidence of dialysis-related complications and complications requiring reinsertion during the first 30 days was significantly lower in PD patients. Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD. The patient survival rate was higher in the PD compared to that in the HD group. Conclusions: PD may be acceptable, safe, and feasible for urgent-start dialysis in ESRD patients with diabetes.

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Impact of Break-In Period on the Short-Term Outcomes of Patients Started on Peritoneal Dialysis

Cited by 58 publications

References 26 publications

Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

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

Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus

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