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Abstract: FR-PO525

The Effect of Hemodialysis with Central Venous Catheterization on Urgent-Start Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Wen-jing, Zhang, The First Affiliated Hospital Of Xi'an Jiaotong University, Xi'an, China
  • Lv, Jia, The First Affiliated Hospital Of Xi'an Jiaotong University, Xi'an, China
  • Wang, Zhi-gang, The First Affiliated Hospital Of Xi'an Jiaotong University, Xi'an, China
  • Li, Yan, The First Affiliated Hospital Of Xi'an Jiaotong University, Xi'an, China
  • Sun, Ji-ping, The First Affiliated Hospital Of Xi'an Jiaotong University, Xi'an, China
Background

Urgent-start peritoneal dialysis(USPD)has received worldwide attention. A number of clinical studies have shown that USPD has great advantages in early complications, technical survival, and medical economics. Due to differences in economic conditions and acceptance, there is no pre-dialysis preparation in most ESRD patients in China.So most patients accept hemodialysis with central venous catheterization (HD-CVC) before deciding on long-term dialysis alternatives. Patients who eventually choose peritoneal dialysis will begin USPD treatment. Whether HD-CVC has effect on USPD that has not been studied. So we investigated the effects of the HD-CVC on USPD.

Methods

Retrospective analysis was performed on patients who received USPD from 2008/08/01 to 2017/03/31 in our hospital.According to whether the patient had HD-CVC before USPD, it was divided into USPD group (HD-CVC was not performed before peritoneal dialysis) and HD-PD group (HD-CVC was given first, and then peritoneal dialysis catheterization was performed within 2 week). The follow-up time was 1 year. The differences in clinical biochemical indexes, dialysis dose, urine volume, residual renal function, dialysis adequacy, peritoneal dialysis complications and technical survival rate between the two groups were observed.

Results

1.A total of 482 patients were included in this study, including 315 patients in the USPD group and 167 patients in the HD-PD group. The gender, age, the proportion of diabetic nephropathy patients, creatinine, glomerular filtration rate, blood potassium before admission were similar between the two groups(P>0.05).2.At 1 month of peritoneal dialysis, residual renal function, UKt/V and TKt/V in the USPD group were significantly higher than those in the HD-PD group, blood urea nitrogen and creatinine were significantly lower than those in the HD-PD group(P<0.05).At 6 months,the urine volume in the USPD group was significantly higher than those in the HD-PD group(P=0.002). 3.The export infection rate, peritonitis infection rate, mechanical complications and technical survival rate were similar between the two groups(P>0.05).

Conclusion

HD-CVC before USPD may affect the residual renal function and dialysis adequacy of patients. Therefore, HD-CVC is not recommended for ESRD patients who need peritoneal dialysis but have no indication of emergency dialysis.