Original InvestigationDialysisUrgent-Start Peritoneal Dialysis: A Quality Improvement Report
Section snippets
Setting
Selected patients with CKD stage 5 admitted to Los Angeles County + University of Southern California (LAC+USC) Medical Center between March 2010 and March 2011 were evaluated and offered PD therapy if deemed candidates. If urgent PD was required, patients were enrolled in a structured urgent-start program and followed up throughout the study period. A comparison non–urgent-start group also was followed.
Patient Safeguards
Safeguards for patient safety, choice, and privacy were achieved by: (1) using a
Baseline Demographics
At baseline, urgent-start patients had a lower estimated glomerular filtration rate (7.4 ± 4.3 vs 11.3 ± 5.4 mL/min/1.73 m2 by the 6-variable MDRD [Modification of Diet in Renal Disease] Study equation) and were less likely to require backup HD therapy (11.1% vs 44%); however, these differences were not statistically significant (P = 0.06 and P = 0.1, respectively). Urgent-start patients were more likely to be men, lack prior renal care, and have uremic symptoms at presentation, but these
Discussion
In certain countries such as Hong Kong, where PD is the dominant dialysis modality, with 80% of the ESRD population on PD therapy, outcomes are similar or better than for HD therapy.19, 20 Many studies have shown an early survival advantage for PD over HD in the first 2 years of therapy, with equivalent outcomes to 5 years.21, 22, 23, 24, 25 Moreover, although overall survival on dialysis therapy has been improving over time, Mehrotra et al26 have shown that patients on PD therapy have had a
Acknowledgements
Support: None.
Financial Disclosure: The author declares that he has no relevant financial interests.
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Cited by (122)
Urgent-start peritoneal dialysis
2023, NefrologiaUrgent Start Peritoneal Dialysis: A Population-Based Cohort Study
2022, Kidney MedicineUrgent start peritoneal dialysis: Is there room for more?
2021, NefrologiaComparison of immediate-start peritoneal dialysis without break-in period and conventional-start peritoneal dialysis: a two-center retrospective audit
2024, International Urology and Nephrology
Originally published online October 24, 2011.