Urgent-start on peritoneal dialysis

Abstract

Introduction: Peritoneal dialysis is under-used in many countries. Usually the admission of acute patients to renal replacement therapy are directed to HD. Urgent start of peritoneal dialysis offers a safe and efficient option to avoid the use of central venous catheters and to increase peritoneal dialysis use. Material and methods: It is a retrospective, observational study comparing patients who started urgent peritoneal dialysis with those that started dialysis in the conventional way, after 4 weeks. Results: 12 peritoneal dialysis patients were analyzed. Six of them under urgent start and the other six received the conventional procedure- Follow-up period was shorter for patients receiving urgent start. There were not significant differences between both groups concerning: age, sex, initial volume, KT/V, albumin, urea, calcium, phosphorus, ferritin, PCR and type of catheter. PTH was significantly lower in patients who received urgent start PD (P≤0.047). Regarding complications: two patients presented leakage of peritoneal fluid and one patient had wall bruising, in the urgent start group. Complications were solved with adequate treatments and did not cause change of methods. Discussion: Urgent start to peritoneal dialysis is a safe method and does not involve major complications. It is a strategy to decrease the use of hemodialysis catheters and to increase number of patients on dialysis peritoneal programs.