Peritoneal dialysis as initial dialysis modality: a viable option for late-presenting end-stage renal disease

Javaid, Muhammad Masoom; Khan, Behram; Subramanian, Srinivas

doi:10.1007/s40620-018-0485-3

Cited by 24 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In urgent/early start PD, both surgical and percutaneous catheter insertions have been described and the prevalence of catheter dysfunction reported varied from 13.3 to 28.9% for surgical [1,13,14] and from 11 to 25.7% for percutaneous placement [2,[5][6][7][8]. In this current study, 12.5% of early start group changed dialysis method for persistent catheter dysfunction, whereas early catheter replacement was more prevalent in planned-start PD.…”

Section: Discussionmentioning

confidence: 68%

See 1 more Smart Citation

Early Start Peritoneal Dialysis: Technique Survival in Long-Term Follow-Up

Silva

Adelina

Pereira

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: Peritoneal dialysis (PD) has gained interest over the last decade as a viable option for early start dialysis. It is still unknown if shorter break-in periods and less time for proper patient evaluation and training could influence technique survival in comparison to planned-start PD. Methods: A prospective and observational study that compared technique survival in a cohort of patients who started either early or planned PD. Early start PD was defined as break-in period from 3 to 14 days with no previous nephrologist follow-up or patient training. Results: A total of 154 patients were included (40 as early start PD), followed by a median time of 381 days. Comparing early vs. planned-start PD, groups were similar concerning age 56 (40; 70) vs. 48 (32; 63) years, p=0.071, body mass index (BMI) 23.3 ± 4.2 vs. 23.8 ± 4.0 kg/m², p=0.567 and male gender (60 vs. 48%, p=0.201), respectively. Comparing early vs. planned-start groups, there were no differences regarding PD dropout for peritonitis (7.5 vs. 11.4%, p=0.764), catheter dysfunction (12.5 vs. 17.5%, p=0.619) and patient burnout (0 vs. 4.4%, p=0.328), respectively. Less patients in early start group quit PD for peritoneal membrane failure in comparison to planned-start group (2.5 vs. 16.7%, p=0.026). In multivariate cox-regression analysis, the only factors independently associated with technique failure were BMI> 25 kg/m² (p=0.033) and Diabetes Mellitus (p=0.013), whereas no differences regarding early vs. planned-PD start were observed (p=0.184). Conclusion: Despite the adverse scenario for initiating dialysis, early start PD had similar outcomes in comparison to planned-start PD in long-term follow-up.

show abstract

Section: Discussionmentioning

confidence: 68%

“…Even though such statement is widely accepted, it is only valid in a planned background, when patient is adequately followed-up by a multi-professional team, with proper training and, most importantly, with a reliable and timely insertion of peritoneal catheter [1].…”

Section: Introductionmentioning

confidence: 99%

Early Start Peritoneal Dialysis: Technique Survival in Long-Term Follow-Up

Silva

Adelina

Pereira

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…However, PD can be a safe, efficient and cost-effective alternative to hemodialysis. Compared to urgent-start haemodialysis via a central venous catheter, urgent-start PD has significantly lower incidences of catheter-related bloodstream infections, dialysis-related complications and need for dialysis catheter re-insertions during the initial phase of the therapy [29].…”

Section: Role Of Pd In Special Scenariosmentioning

confidence: 99%

Peritoneal dialysis: the ideal bridge from conservative therapy to kidney transplant

Tang

Lai

2020

J Nephrol

View full text Add to dashboard Cite

Background Kidney transplantation offers the best potential for full rehabilitation in patients with end-stage kidney disease who are treated with dialysis. However, due to organ shortage which is a universal phenomenon, most patients need to be maintained on a period of dialysis therapy before the prospect of transplantation. Peritoneal dialysis (PD) could be an ideal form of renal replacement therapy due to its favorable profile toward preservation of residual renal function, patient survival, lower overall burden on cardiovascular morbidity and infection risks. Methods With extensive experience in PD therapy from Hong Kong where PD-first is a mandatory health policy, we reviewed the literature and present current evidence that favors PD as an optimal form of bridging renal replacement therapy prior to kidney transplantation. Results PD provides a viable and advantageous form of renal reaplcement particularly in terms of preservation of residual renal function, patient survival and quality of life, and cost among many other factors. Potential misconceptions that PDrelated peritonitis and dialysis inadequacy are potentially deterrent factors for initiating PD therapy are clarified. Conclusion PD is a practical and noninferior form of renal replacement that serves as an ideal bridge from conservative therapy to kidney transplantation.

show abstract

“…Peritoneal Dialysis (PD) is an established home care, costeffective kidney replacement therapy, which compared to hemodialysis (HD), offers several advantages including better preservation of residual renal function, a more gradual and continuous solute and fluid clearance, minimal cardiac stress, and similar survival [1]. Several studies over the last decade also show that PD may be a safe and efficient alternative to HD in late-presenting ESRD patients requiring urgent start of dialysis [2]. The dialysate composition includes physiological concentrations of chloride, calcium, sodium, magnesium, and a buffer (lactate and/or bicarbonate).…”

Section: Introductionmentioning

confidence: 99%

The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis

et al. 2020

View full text Add to dashboard Cite

Peritoneal dialysis (PD) is a viable but under-prescribed treatment for uremic patients. Concerns about its use include the bio-incompatibility of PD fluids, due to their potential for altering the functional and anatomical integrity of the peritoneal membrane. Many of these effects are thought to be due to the high glucose content of these solutions, with attendant issues of products generated during heat treatment of glucose-containing solutions. Moreover, excessive intraperitoneal absorption of glucose from the dialysate has many potential systemic metabolic effects. This article reviews the efforts to develop alternative PD solutions that obviate some of these side effects, through the replacement of part of their glucose content with other osmolytes which are at least as efficient in removing fluids as glucose, but less impactful on patient metabolism. In particular, we will summarize clinical studies on the use of alternative osmotic ingredients that are commercially available (icodextrin and amino acids) and preclinical studies on alternative solutions under development (taurine, polyglycerol, carnitine and xylitol). In addition to the expected benefit of a glucose-sparing approach, we describe an 'osmo-metabolic' approach in formulating novel PD solutions, in which there is the possibility of exploiting the pharmaco-metabolic properties of some of the osmolytes to attenuate the systemic side effects due to glucose. This approach has the potential to ameliorate pre-existing co-morbidities, including insulin resistance and type-2 diabetes, which have a high prevalence in the dialysis population, including in PD patients.

show abstract

Peritoneal dialysis as initial dialysis modality: a viable option for late-presenting end-stage renal disease

Cited by 24 publications

References 18 publications

Early Start Peritoneal Dialysis: Technique Survival in Long-Term Follow-Up

Early Start Peritoneal Dialysis: Technique Survival in Long-Term Follow-Up

Peritoneal dialysis: the ideal bridge from conservative therapy to kidney transplant

The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis

Contact Info

Product

Resources

About