Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Nov 9

PMID 27824950

Citations 32

Authors

Haijiao Jin

Wei Fang

Mingli Zhu

Zanzhe Yu

Yan Fang

Hao Yan

Minfang Zhang

Qin Wang

Xiajing Che

Yuanyuan Xie

Jiaying Huang

Chunhua Hu

Haifen Zhang

Shan Mou

Zhaohui Ni

Affiliations

Soon will be listed here.

Abstract

Background: Several studies have suggested that urgent-start peritoneal dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients with end-stage renal disease (ESRD), but the impact of the dialysis modality on outcome, especially on short-term complications, in urgent-start dialysis has not been directly evaluated. The aim of the current study was to compare the complications and outcomes of PD and HD in urgent-start dialysis ESRD patients.

Methods: In this retrospective study, ESRD patients who initiated dialysis urgently without a pre-established functional vascular access or PD catheter at a single center from January 2013 to December 2014 were included. Patients were grouped according to their dialysis modality (PD and HD). Each patient was followed for at least 30 days after catheter insertion (until January 2016). Dialysis-related complications and patient survival were compared between the two groups.

Results: Our study enrolled 178 patients (56.2% male), of whom 96 and 82 patients were in the PD and HD groups, respectively. Compared with HD patients, PD patients had more cardiovascular disease, less heart failure, higher levels of serum potassium, hemoglobin, serum albumin, serum pre-albumin, and lower levels of brain natriuretic peptide. There were no significant differences in gender, age, use of steroids, early referral to a nephrologist, prevalence of primary renal diseases, prevalence of co-morbidities, and other laboratory characteristics between the groups. The incidence of dialysis-related complications during the first 30 days was significantly higher in HD than PD patients. HD patients had a significantly higher probability of bacteremia compared to PD patients. HD was an independent predictor of short-term (30-day) dialysis-related complications. There was no significant difference between PD and HD patients with respect to patient survival rate.

Conclusion: In an experienced center, PD is a safe and feasible dialysis alternative to HD for ESRD patients with an urgent need for dialysis.

Citing Articles

A Randomized Controlled Trial Comparing Automated Peritoneal Dialysis and Hemodialysis for Urgent-Start Dialysis in ESRD.

Jin H, Fang W, Wang L, Zang X, Deng Y, Wu G Kidney Int Rep. 2024; 9(9):2627-2634.

PMID: 39291207 PMC: 11403029. DOI: 10.1016/j.ekir.2024.06.032.

Peritoneal dialysis versus haemodialysis for people commencing dialysis.

Ethier I, Hayat A, Pei J, Hawley C, Johnson D, Francis R Cochrane Database Syst Rev. 2024; 6:CD013800.

PMID: 38899545 PMC: 11187793. DOI: 10.1002/14651858.CD013800.pub2.

The effect of urgent-start peritoneal dialysis and urgent-start hemodialysis on clinical outcomes in patients with chronic kidney disease: an updated systematic review and meta-analysis.

Duan P, Zhang H, Zhang Y Int Urol Nephrol. 2024; 56(7):2301-2312.

PMID: 38441869 DOI: 10.1007/s11255-024-03999-6.

Cardiac Surgery Outcomes in Patients Receiving Hemodialysis Versus Peritoneal Dialysis.

Bassil E, Matta M, El Gharably H, Harb S, Calle J, Arrigain S Kidney Med. 2024; 6(3):100774.

PMID: 38435071 PMC: 10907222. DOI: 10.1016/j.xkme.2023.100774.

A comparison of urgent-start of hemodialysis vs urgent initiation of peritoneal dialysis: a meta-analysis study.

Qi Y, Zhang W, Wang J Int Urol Nephrol. 2024; 56(6):2031-2043.

PMID: 38191865 DOI: 10.1007/s11255-023-03904-7.

References

Liyanage T, Ninomiya T, Jha V, Neal B, Patrice H, Okpechi I . Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015; 385(9981):1975-82. DOI: 10.1016/S0140-6736(14)61601-9. View

de Jong P, Bakker S, Gansevoort R . What to measure-albuminuria or total proteinuria?. Am J Kidney Dis. 2010; 57(1):1-2. DOI: 10.1053/j.ajkd.2010.11.005. View

Povlsen J, Ivarsen P . How to start the late referred ESRD patient urgently on chronic APD. Nephrol Dial Transplant. 2006; 21 Suppl 2:ii56-9. DOI: 10.1093/ndt/gfl192. View

Ghaffari A . Urgent-start peritoneal dialysis: a quality improvement report. Am J Kidney Dis. 2011; 59(3):400-8. DOI: 10.1053/j.ajkd.2011.08.034. View

Dias D, Banin V, Mendes M, Barretti P, Ponce D . Peritoneal dialysis can be an option for unplanned chronic dialysis: initial results from a developing country. Int Urol Nephrol. 2016; 48(6):901-6. DOI: 10.1007/s11255-016-1243-x. View

Sharma A, Mandhani A, Daniel S, Filler G . Shorter break-in period is a viable option with tighter PD catheter securing during the insertion. Nephrology (Carlton). 2008; 13(8):672-6. DOI: 10.1111/j.1440-1797.2008.01000.x. View

Lorenzo V, Martn M, Rufino M, Hernandez D, Torres A, Ayus J . Predialysis nephrologic care and a functioning arteriovenous fistula at entry are associated with better survival in incident hemodialysis patients: an observational cohort study. Am J Kidney Dis. 2004; 43(6):999-1007. DOI: 10.1053/j.ajkd.2004.02.012. View

Alkatheeri A, Blake P, Gray D, Jain A . Success of Urgent-Start Peritoneal Dialysis in a Large Canadian Renal Program. Perit Dial Int. 2015; 36(2):171-6. PMC: 4803362. DOI: 10.3747/pdi.2014.00148. View

. III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: update 2000. Am J Kidney Dis. 2001; 37(1 Suppl 1):S137-81. DOI: 10.1016/s0272-6386(01)70007-8. View

10.

Dombros N, Dratwa M, Feriani M, Gokal R, Heimburger O, Krediet R . European best practice guidelines for peritoneal dialysis. 3 Peritoneal access. Nephrol Dial Transplant. 2005; 20 Suppl 9:ix8-ix12. DOI: 10.1093/ndt/gfi1117. View

11.

Liangos O, Gul A, Madias N, Jaber B . Long-term management of the tunneled venous catheter. Semin Dial. 2006; 19(2):158-64. DOI: 10.1111/j.1525-139X.2006.00143.x. View

12.

Liu Y, Zhang L, Lin A, Ni Z, Qian J, Fang W . Impact of break-in period on the short-term outcomes of patients started on peritoneal dialysis. Perit Dial Int. 2014; 34(1):49-56. PMC: 3923692. DOI: 10.3747/pdi.2012.00293. View

13.

Lobbedez T, Lecouf A, Ficheux M, Henri P, Hurault de Ligny B, Ryckelynck J . Is rapid initiation of peritoneal dialysis feasible in unplanned dialysis patients? A single-centre experience. Nephrol Dial Transplant. 2008; 23(10):3290-4. DOI: 10.1093/ndt/gfn213. View

14.

Lee T, Barker J, Allon M . Tunneled catheters in hemodialysis patients: reasons and subsequent outcomes. Am J Kidney Dis. 2005; 46(3):501-8. DOI: 10.1053/j.ajkd.2005.05.024. View

15.

Dean D, Cruz D . We Use Permcaths Instead of Peritoneal Catheters for Acute Kidney Injury and Urgent-Start Dialysis. Semin Dial. 2016; 29(4):260-2. DOI: 10.1111/sdi.12487. View

16.

Liu F, Ghaffari A, Dhatt H, Kumar V, Balsera C, Wallace E . Economic evaluation of urgent-start peritoneal dialysis versus urgent-start hemodialysis in the United States. Medicine (Baltimore). 2014; 93(28):e293. PMC: 4603112. DOI: 10.1097/MD.0000000000000293. View

17.

Lok C, Foley R . Vascular access morbidity and mortality: trends of the last decade. Clin J Am Soc Nephrol. 2013; 8(7):1213-9. DOI: 10.2215/CJN.01690213. View

18.

Rehman R, Schmidt R, Moss A . Ethical and legal obligation to avoid long-term tunneled catheter access. Clin J Am Soc Nephrol. 2009; 4(2):456-60. DOI: 10.2215/CJN.03840808. View

19.

Ravani P, Palmer S, Oliver M, Quinn R, MacRae J, Tai D . Associations between hemodialysis access type and clinical outcomes: a systematic review. J Am Soc Nephrol. 2013; 24(3):465-73. PMC: 3582202. DOI: 10.1681/ASN.2012070643. View

20.

Johnson D, Dent H, Hawley C, McDonald S, Rosman J, Brown F . Associations of dialysis modality and infectious mortality in incident dialysis patients in Australia and New Zealand. Am J Kidney Dis. 2008; 53(2):290-7. DOI: 10.1053/j.ajkd.2008.06.032. View