Outcomes of early‐start peritoneal dialysis (PD) and the comparison with urgent‐start hemodialysis and conventional‐start PD

Abstract

Background: Limited data in the literature is comparing early-start peritoneal dialysis (PD), urgent-start hemodialysis (HD) with the jugular central venous catheter (CVC), and conventional-start PD. Methods: This retrospective study was conducted with 148 patients with early-start PD, 104 patients with conventional-start PD, and 100 patients with urgent-start HD. Early-start PD was defined as catheter break-in time between 3 and 14 days. Results:The occurrence of dialysate-leakage was similar between PD groups (p = 0.1). Bleeding at the catheter site was detected in 8 (2.3%) patients with CVC. There was no significant difference in catheter dysfunction and revision.PD groups had statistically similar peritonitis rates (p = 0.5). 19% (19/100) of patients suffered CVC-related bloodstream infection and one patient died due to septic shock. Technique survival was significantly higher at early-start PD than the conventional-start PD at 6 months (p = 0.02). Conclusion:Initiating early-start PD is comparable with conventional-start PD, and it may be an alternative dialysis modality to avoid bloodstream infections in suitable patients.

Comparison of Unplanned/Urgent‐Start Versus Conventional‐Start Peritoneal Dialysis: A Systematic Review and Meta‐Analysis

“…Primary screening of the databases identified 842 citations. Following duplicates removal, 70 full‐text articles underwent secondary screening, and a total of 27 studies that satisfied the eligibility criteria were included in the analysis (Figure 1) [9–12, 17–39].…”

The influence of different peritoneal dialysis techniques on wound infection in patients with peritoneal dialysis tube

“…The results are presented in Table 2. This study included 3034 PD participants, 1458 urgent start PD and 1576 conventional initiated PD 18–32 . The overall sample size was between 7 and 433 individuals.…”

“…This study included 3034 PD participants, 1458 urgent start PD and 1576 conventional initiated PD. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The overall sample size was between 7 and 433 individuals. Urgent start PDs were greater with respect to the risk of leakage from the conduit than with the conventional baseline PD (OR, 2.48; 95% CI, 1.72, 3.59, p < 0.00001), Figure 3.…”

“…9 In this meta-analysis, 3034 PD patients were enrolled at baseline, 1758 in the urgent-initiated PD arm and 15,76 in the conventional PD group. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Patients with urgent-initiated PD were at a greater risk for conduit fluid leaks than those with conventional PD. But they were similar with respect to the risk of peritonitis, catheter dysfunction, catheter exit site infection and bleeding.…”

“…In this meta‐analysis, 3034 PD patients were enrolled at baseline, 1758 in the urgent‐initiated PD arm and 15,76 in the conventional PD group 18–32 . Patients with urgent‐initiated PD were at a greater risk for conduit fluid leaks than those with conventional PD.…”