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Kidney Week

Abstract: FR-PO671

Early Complications of Urgent-Start Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Wang, Ying, Peking Union Medical College Hospital, Beijing, China
  • Wang, Haiyun, Peking Union Medical College Hospital, Beijing, China
  • Ma, Ying, Peking Union Medical College Hospital, Beijing, China
  • Li, Yang, Peking Union Medical College Hospital, Beijing, China
  • Liu, Bingyan, Peking Union Medical College Hospital, Beijing, China
  • Zhou, Zijuan, Peking Union Medical College Hospital, Beijing, China
  • Yang, Wei, Peking Union Medical College Hospital, Beijing, China
  • Li, Xuemei, Peking Union Medical College Hospital, Beijing, China
  • Chen, Limeng, Peking Union Medical College Hospital, Beijing, China
Background

Urgent-start peritoneal dialysis (PD) would be an effective option for patients need unplanned dialysis. However, the early catheter-related complications in urgent-start PD have not been well investigated and the previous results were inconsistent.

Methods


In this retrospective study, end stage renal disease (ESRD) patients were included if they were over 18 years old and received regular PD in our PD center between 1 March 1996 and 30 September 2016. Urgent-start PD was defined as initiation of PD within 2 weeks of catheter insertion. The time from placement-to-PD was determined by the nephrologists based on the clinical condition of each patient. Patients were divided into two groups according to whether PD was started urgently or not. The outcome was mechanical and infectious complications and technique survival in the first 6 months.

Results


A total of 667 patients (203 urgent-start, 464 conventional-start) were included. The mean age of the study patients was 59.6±15.4 years old, and 49.8% of the patients were female. Diabetes was the primary cause of ESRD (36.1%) and was followed by glomerulonephropathy (25.6%) and hypertension (20.5%). The time from catheter insertion to PD initiation was 8.1±4.5 and 18.6±12.7 days in urgent-start and conventional-start PD group, respectively. Compared with conventional-start patients, urgent-start patients had lower serum albumin, Kt/v, Ccr and eGFR levels at the start of PD, and otherwise there was no significant difference between the two groups. The rate of mechanical complications at 1 month, 3 months, and 6 months after PD commencement was 9.4%, 16.7%, and 18.2% in the urgent-start PD group, respectively. The rate of infectious complications at the same time points was 11.8%, 13.8%, and 20.7% in the urgent-start group. Technique survival was 96.9% and 98.4% in urgent-start and conventional-start PD group, respectively. There was no difference in the rate of mechanical and infectious complications and technique survival between urgent- and conventional-start PD patients at either time point.

Conclusion

Urgent-start PD patients had similar rates of catheter-related complications and technique survival compared with conventional-start PD patients.