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Kidney Week

Abstract: TH-PO314

Urgent Start Peritoneal Dialysis (PD) as a Safe and Effective Dialysis Modality to Reduce the Dropout of Patients on Peritoneal Dialysis

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Hussain, Mohammed Ezzat, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ghonimi, Tarek Abdellatif, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ali, Nahid Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Ahmed, Hanaa, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
Background

PD dropout became a major factor affecting the unitized PD program and created a new burden in the setting of limited HD slots. Our registry shows that almost 35-50 % yearly for the last 3 years of patients who choose PD as a permanent dialysis modality and started temporary HD through Permcath till the maturation of the PD catheter will change their mind and request to be kept on HD and removal of PD catheter even before starting PD training.
Urgent start PD program started by keeping CKD 5 patients eligible to start PD on one vascular access (PD catheter) without Permcath insertion and start Peritoneal dialysis 48hrs post PD catheter insertion.
The safety and efficacy of the program were evaluated through monitor any mechanical complications and patient satisfaction besides our regular parameters such as volume status and electrolytes.

Methods

Identified CKD-5 patients during ED visits with eithe an earlier plan for PD as a dialysis modality or having no plan. We evaluated the emergency and urgent need to start Renal replacement therapy. We created an Urgent Start PD pathway for those patients without the emergency need to start or who had an emergency need and became stable after starting HD through a temporary dialysis catheter.
They were referred to vascular surgeons for PD catheter insertion after checking suitability and liability to Peritoneal dialysis. PD will start 48 hrs. after insertion.
We enrolled sixteen patients from October 2022 till April 2023, all of them were started on APD but the final PD model is decided after completing both APD and CAPD training. Body surface area was the main factor that affected APD Prescription.
Frequent PD clinic visits were arranged to readjust the PD regimen and monitor mechanical complications, patient satisfaction, volume status, and electrolytes.

Results

Almost all patients were discharged with satisfactory conditions & accepted electrolytes without any mechanical complications and with fewer dates of admission after starting the new program.

Conclusion

Urgent start PD seems to be a safe, effective, and reasonable way to reduce PD dropout in addition to reducing cost and total days of hospitalization.
We need a larger number of patients and a longer duration to generalize the findings of these observations.