Abstract: TH-PO868

Feasibility of Urgent-Start Peritoneal Dialysis in Older Patients with ESRD: A Single-Center Experience

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

  • Jin, Haijiao, Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • Ni, Zhaohui, None, Shanghai, SHANGHAI, China
Background

Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative method of urgent dialysis, including in older patients.

Methods

This retrospective study enrolled patients aged >65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single-center, from January 2011 to December 2014. Patients were grouped based on their dialysis modality (PD or hemodialysis [HD]). Patients unable to tolerate PD-catheter insertion or wait for PD were excluded. Each patient was followed for at least 30 days after catheter insertion. Short-term (30-day) dialysis-related complications and patient survival were compared between the two groups.

Results

A total of 94 patients were enrolled, including 53 (56.4%) who underwent PD. The incidence of dialysis-related complications during the first 30 days was significantly lower in PD compared with HD patients (3 [5.7%] vs. 10 [24.4%], P=0.009). Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD (odds ratio 4.760 [1.183–19.147], P=0.028). The 6-, 12-, 24-, and 36-month survival rates in the PD and HD groups were 92.3% vs. 94.6%, 82.4% vs. 81.3%, 75.7% vs. 74.2%, and 69.5% vs. 60.6%, respectively, with no significant differences between the groups (log-rank=0.011, P=0.915).

Conclusion

Urgent-start PD was associated with fewer short-term dialysis-related complications without affecting survival compared with urgent-start HD in older patients with ESRD. PD may thus be a safe and effective dialysis modality for older ESRD patients requiring urgent dialysis.

Funding

  • Government Support - Non-U.S.