Success of Urgent-Start Peritoneal Dialysis in a Large Canadian Renal Program

Alkatheeri, Ali M.A.; Blake, Peter G.; Gray, Daryl; Jain, Arsh K.

doi:10.3747/pdi.2014.00148

Cited by 99 publications

(114 citation statements)

References 17 publications

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“…Initiating PD acutely via "urgent start PD" programs has been shown to be a safe alternative to HD in patients without an established AV fistula or graft. 58 Should no options exist outside of HD catheter placement, proper catheter care and infection control procedures are the first step in preventing infections. Auditing and educating both patients and dialysis unit personnel are of the utmost importance.…”

Section: Resultsmentioning

confidence: 99%

Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies

Soi¹,

Moore²,

Kumbar³

et al. 2016

IJNRD

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Catheter-related bloodstream infections are a significant source of morbidity and mortality in the end-stage renal disease population. Although alternative accesses to undergoing renal replacement therapy exist, many patients begin hemodialysis with a dialysis catheter due to logistic and physiologic factors involved in arteriovenous fistula creation and maturation. Colonization of catheters via skin flora leads to the production of biofilm, which acts as a reservoir for virulent bacteria. Preventative therapies center on appropriate catheter maintenance, infection control measures, and early removal of devices as patients transition to other access. Despite best efforts, when conservative measures fail to prevent infections in a high-risk population, antimicrobial lock therapy should be considered as an option to combat catheter-related bloodstream infections.

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Section: Resultsmentioning

confidence: 99%

Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies

Soi¹,

Moore²,

Kumbar³

et al. 2016

IJNRD

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show abstract

“…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 PD can be a welcome alternative to HD via CVC for uremic or fluid overloaded patients requiring the unplanned initiation of dialysis [2,3,4,5,6,7]. …”

Section: Discussionmentioning

confidence: 99%

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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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“…Alkatheeri et al 29 recently described the initial Canadian experience with urgent-start peritoneal dialysis. In a prospective observational study, the authors followed 30 incident patients on PD with unplanned starts and analyzed cases of mechanical complications and infection.…”

Section: Introductionmentioning

confidence: 99%