Kidney Week

Abstract: TH-PO828

Urgent-Start Peritoneal Dialysis by the Nephrologist

Session Information

• Peritoneal Dialysis - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 608 Peritoneal Dialysis

Authors

• Soto-Vargas, Javier, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Javier Soto-Vargas,

• López, Heriberto Reyes, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Heriberto Reyes López,

• Vargas ezquivel, Martín D., Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Martín D. Vargas ezquivel,

• Jiménez Mejía, Carlos Daniel, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Carlos Daniel Jiménez Mejía,

• Garc?a-Vera, Ana Lya, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Ana Lya Garc?a-Vera,

• Cortina, Rodolfo A., ISSSTE, MEXICO CITY, Mexico

Rodolfo A. Cortina,

• Ramos, Alfonso, Baxter Mexico, San Jer?nimo Chicahualco, Mexico

Alfonso Ramos,

• Parra, Renato, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Renato Parra,

• Garc?a C?rdenas, Mario A., Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Jalisco, Mexico

Mario A. Garc?a C?rdenas,

Background

Urgent-start peritoneal dialysis is an alternative to initiation of renal support in patients with end-stage renal disease. The objective is to describe our experience with an urgent-start PD program.

Methods

In this prospective observational study, we report on our experience in a single academic center. All patients treated with urgent-start PD, defined as PD therapy initiated within 1 week after catheter insertion, and from September 2016 to April 2017 were included. Peritoneal dialysis catheters were inserted percutaneously by punction. Dialysis was initiated in an inpatient setting whit a fix dose of 60 liters in fast cycles.

Results

Seventy three patients were started on urgent PD during our study period. Follow-up of 30.5 days (IQR 25-55.5). Dialysis was initiated with a median of 1 day (IQR, 0.6-2.0). The major indications for treatment were acidosis and uremic syndrome. The median hemoglobin was 8 g/dL (IQR 6.9-8.9), urea 224.5 mg/dL (194-293), potassium 4.8 mEq/dL (IQR 4.1-5.4), pH 7.32 (IQR 7.2-7.38) and HCO3 12.8 mEq (IQR 9.5-16.1). Twenty-five patients (34%) developed a mechanical complication of which: nine (12.2%) were peri-catheter leak, flow dysfunction in 7 (9.5%) patients and 6 (8.1%) cases of peri-catheter bleed. Eight (10.8%) patients required catheter removal and reinsertion, and only one (1.4%) patient required modality switch. No demographic or biochemical characteristic was associated with the development of any complication.

Conclusion

Urgent-start PD is an acceptable and safe alternative compared to hemodialysis for initiation of renal support in patients with end-stage renal disease.