Truly Urgent “Urgent-Start” Peritoneal Dialysis

Chiu, Michael; Jain, Arsh K.; Blake, Peter G.

doi:10.1016/j.ekir.2020.08.025

Cited by 3 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, the mean phosphorus was significantly higher in patients with urgent start HD than those with early-start PD and conventional-start PD (5.79 ± 1.88 mg/dl vs. 4.61 ± 1.4 mg/dl vs. 4.55 ± 1.10 mg/dl, p < 0.001). While the median PD catheter break-in time in the earlystart PD group was 11 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days, it was 26 (15-152) days in patients with conventional-start PD (p < 0.001). Demographic characteristics and baseline laboratory parameters of the study population are shown in Table 1.…”

Section: Resultsmentioning

confidence: 92%

“…The definition of urgent-start PD is based on the onset of renal replacement therapy after intra-peritoneal catheter insertion, and treatment must initiate within 14 days [9,10]. There is no standardization in the catheter break-in time in the literature, and some of the authors suggest that truly urgent-start PD definition is to initiate PD within 72 h, and starting PD within 3-14 days should be defined as early-start PD [11]. The clarification of the initiation time is crucial to identify the best time interval for the minimal mechanical complication risk.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2022

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…However, for acute indications, such as urgent metabolic states or severe organ failure, dialysis is started on the day of catheter placement, immediately following the surgery. Initiating dialysis up to 72 h post-op may be referred to as "truly urgent" USPD [53]. The starting volume for the first few days is usually under 1 L and is gradually increased to 2 L, or other tolerable maximum volumes [43,54].…”

Section: Initiation Of Treatment and Aftercare In Uspdmentioning

confidence: 99%

Urgent Implantation of Peritoneal Dialysis Catheter in Chronic Kidney Disease and Acute Kidney Injury—A Review

Cholerzyńska

Zasada

Michalak

et al. 2023

JCM

View full text Add to dashboard Cite

Acute kidney injury (AKI) and sudden exacerbation of chronic kidney disease (CKD) frequently necessitate urgent kidney replacement therapy (UKRT). Peritoneal dialysis (PD) is recognized as a viable modality for managing such patients. Urgent-start peritoneal dialysis (USPD) may be associated with an increased number of complications and is rarely utilized. This review examines recent literature investigating the clinical outcomes of USPD in CKD and AKI. Relevant research was identified through searches of the MEDLINE (PubMed), Scopus, Web of Science, and Google Scholar databases using MeSH terms and relevant keywords. Included studies focused on the emergency use of peritoneal dialysis in CKD or AKI and reported treatment outcomes. While no official recommendations exist for catheter implantation in USPD, the impact of the technique itself on outcomes was found to be less significant compared with the post-implantation factors. USPD represents a safe and effective treatment modality for AKI, although complications such as catheter malfunctions, leakage, and peritonitis were observed. Furthermore, USPD demonstrated efficacy in managing CKD, although it was associated with a higher incidence of complications compared to conventional-start peritoneal dialysis. Despite its cost-effectiveness, PD requires greater technical expertise from medical professionals. Close supervision and pre-planning for catheter insertion are essential for CKD patients. Whenever feasible, an urgent start should be avoided. Nevertheless, in emergency scenarios, USPD does remain a safe and efficient approach.

show abstract

“…Historically, urgent-start PD is used with caution due to potentially increased risks of complications, such as catheter malposition or leak, and peritonitis, given the insufficient healing time post-catheter insertion [7]. However, a successful urgent-start PD may eliminate the requirement of temporary vascular access for hemodialysis, which also carries its own inherent set of complications and challenges [8].…”

Section: Introductionmentioning

confidence: 99%

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

Xu,

Jiang

2024

Seminars in Dialysis

View full text Add to dashboard Cite

The timing of peritoneal dialysis (PD) initiation, whether conventional‐start (planned) or urgent‐start (unplanned), may impact the outcomes of PD and the rate of associated complications in individuals with chronic kidney disease (CKD). The goal of this study was to evaluate the effects of unplanned/urgent‐start PD versus conventional‐start PD in this cohort of patients. Electronic search of MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases was done from inception until July 2023 for studies reporting outcomes of unplanned/urgent‐start and conventional‐start PD in CKD patients. Outcomes of interest included mechanical complications, post‐procedure infections, mortality, and transfer to hemodialysis. Heterogeneity, publication bias, and the influence of individual studies on the pooled odds ratio (OR) with 95% confidence interval (CI) were evaluated. Twenty‐seven studies were finally included in the review. The overall risk of post‐procedure infectious was comparable for both PD initiation methods (OR: 1.05; 95% CI: 0.83–1.34). Similarly, the risks for peritonitis and exit site infections did not differ significantly. However, urgent‐start PD correlated with a significantly higher risk of overall mechanical complications (OR: 1.70; 95% CI: 1.23–2.34). Specifically, the risk for leaks was notably higher (OR: 2.47; 95% CI: 1.67–3.65) in the urgent‐start group compared to the conventional‐start PD group. Urgent‐start PD correlated with significantly increased mortality rates (OR: 1.83; 95% CI: 1.39–2.41). There was no difference in the likelihood of technique survival and transfer to hemodialysis. Both urgent‐start and conventional‐start PD correlated with similar risks of overall infectious complications. Urgent‐start PD resulted in significantly increased risks of mechanical complications and mortality. Our findings emphasize the need for meticulous planning and consideration when opting for PD initiation.

show abstract

Truly Urgent “Urgent-Start” Peritoneal Dialysis

Cited by 3 publications

References 9 publications

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

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

Urgent Implantation of Peritoneal Dialysis Catheter in Chronic Kidney Disease and Acute Kidney Injury—A Review

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

Contact Info

Product

Resources

About