Abstract: FR-PO0528
Outcomes of Initiating Peritoneal Dialysis vs. Hemodialysis in Severe Kidney Failure
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Gómez Fregoso, Juan, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- De la Torre De la Vega, Ixchel, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Ramírez, Narda Carolina, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Navarro Blackaller, Guillermo, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Medina, Ramon, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Alcantar Vallin, Maria de la Luz, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Martínez Gallardo González, Alejandro, Universidad de Guadalajara, Guadalajara, Jal., Mexico
Background
Urgent start peritoneal dialysis (PD) may be often avoided due to concerns of efficacy among those with symptomatic kidney failure. We sought to evaluate mortality risks and other clinical outcomes in individuals starting PD vs. hemodialysis (HD) urgently restricted to those with symptomatic kidney failure
Methods
In this prospective single-center cohort, individuals who were dialysis-naive and hospitalized with symptomatic kidney failure defined as a urea value >300 mg/dL were eligible. Primary outcome was 90-day mortality between those starting PD and HD. Secondary outcomes were to changes in biochemical parameters (potassium, sodium, bicarbonate), ability to remain on the initial dialysis modality, fluid removal and PD and HD access complications.
Results
Between May 2022-2024, 120 received PD and 103 received HD being 73% male with a median age of 43 years. Mortality at 90 days was 29.1% for HD and 20.8% for PD died at 90 days with an adjusted risk of death (aHR of 1.26, 95% CI 0.73 to 2.18). The urea value decreased more than 50% in both techniques (p = 0.10) within the first seven days, with similar trends for serum potassium and bicarbonate. The total ultrafiltrate was greater by 1.2 liters in the HD compared with PD (p = 0.005). Catheter dysfunction was lower in patients who received HD compared to those on PD (13.6% vs 26.7% (95% CI 2.7 to 23-5 p= 0.01). By 90 days, 5.5% patients in HD were switched to PD, and 10.5% patients of the PD were switched to HD, but this difference was not significant (p= 0.27).
Conclusion
Among individuals with severe and symptomatic kidney failure outcomes were similar between urgent start HD and PD. Further studies are necessary to confirm these results.