Unplanned vs. planned peritoneal dialysis as initial therapy for dialysis patients in chronic kidney replacement therapy.

AIM: To compare infectious and mechanical complications, technique failure and mortality of a planned PD vs. an unplanned PD program. DESIGN: It was a prospective observational study that included chronic kidney disease (CKD) patients who started PD according to medical recommendation: group1-planned and group 2-unplanned PD. METHODS: This study evaluated patients who started planned and unplanned PD programs in a teaching hospital from July 2014 to December 2017. RESULTS: A total of 58 patients were included in the planned PD group and 113 in the unplanned PD group. There was difference between the two groups in leak and hospital admissions, that were more frequent in the unplanned PD group. Periods free from exite site infection, peritonitis and mechanical complications were longer in the planned group. Cox regression analysis identified age and the lowest albumin value as factors associated with mechanical complications; peritonitis indicated the presence of ESI and mechanical complications; the change to HD was associated with a younger age, mechanical complications, diabetes mellitus (DM) and peritonitis. The factors associated with death were age and lower values of albumin. After 48 months, the growth of the PD program was 252%. CONCLUSION: The technique survival and patient mortality in unplanned PD was similar to planned PD, while the period marked by the absence of complications related to PD was longer in the planned PD group. In the Cox regression, unplanned PD was not identified as risk factor for death, transition to HD or complications related to therapy, while age and lower albumin values were predictors of negative outcomes. IMPACT: Unplanned PD is not risk factor for death and complications related to PD and can be an option to unplanned HD.

Visita domiciliar como suporte da enfermagem na diálise peritoneal: revisão integrativa / Visita domiciliaria como asistencia de enfermería en la diálisis peritoneal: revisión integradora / Home visit as a support for nursing in peritoneal dialysis: an integrative review

Resumo Objetivo Identificar na literatura como a visita domiciliar é utilizada pelo enfermeiro como ferramenta do cuidado em dialise peritoneal domiciliar. Métodos Revisão integrativa da literatura de artigos em periódicos, a partir de uma questão norteadora, no período de janeiro de 2014 a janeiro de 2019. A busca bibliográfica foi realizada nas bases Scielo; Web of Science, Pubmed, Scopus, Embase e Cinahl. Resultados Identificaram-se 10 artigos de acordo com as etapas da revisão e as respostas à pergunta norteadora. A visita domiciliar realizada pelo enfermeiro foi descrita como ferramenta de adesão ao tratamento. A prevenção de complicações, como a peritonite, foi citada pelos autores, que em sua maioria, eram médicos e enfermeiros. Conclusão O enfermeiro assiste integralmente ao paciente e família e, assegura o tratamento proposto com fidedignidade. As intervenções de enfermagem no domicílio previnem eventos adversos e frequente avaliação de indicadores do tratamento. Estimular estudos primários nessa área é imprescindível, visto que poucos estudos sobre a temática foram identificados na presente revisão.

Resumen Objetivo Identificar en la literatura cómo se utiliza la visita domiciliaria del enfermero como herramienta de cuidado en diálisis peritoneal domiciliaria. Métodos Revisión integradora de la literatura de artículos en revistas especializadas, a partir de una pregunta orientadora, en el período de enero de 2014 a enero de 2019. La búsqueda bibliográfica fue realizada en las bases Scielo, Web of Science, Pubmed, Scopus, Embase y Cinahl. Resultados Se identificaron diez artículos de acuerdo con las etapas de la revisión y las respuestas a la pregunta orientadora. La visita domiciliaria realizada por el enfermero se describió como herramienta de adherencia al tratamiento. La prevención de complicaciones, como la peritonitis, fue citada por los autores que, en su mayoría eran médicos y enfermeros. Conclusión El enfermero asiste al paciente y a la familia de forma integral y garantiza que el tratamiento propuesto sea fidedigno. Las intervenciones de enfermería en el domicilio previenen eventos adversos y una evaluación frecuente de indicadores del tratamiento. Es imprescindible estimular estudios primarios en esta área, ya que se identificaron pocos estudios sobre esta temática en la presente revisión.

Abstract Objective To identify in the literature how home visit is used by nurses as a tool of care in home peritoneal dialysis. Methods An integrative review of the literature of articles in journals, from a guiding question, from January 2014 to January 2019. The bibliographic search was carried out at Scielo, Web of Science, Pubmed, Scopus, Embase, and CINAHL databases. Results Ten articles were identified according to the review steps and the answers to the guiding question. The home visit performed by nurses was described as a treatment adherence tool. Complication prevention, such as peritonitis, was cited by the authors, who were mostly physicians and nurses. Conclusion Nurses assist patients and family members in full and ensure the proposed treatment with reliability. Nursing interventions at home prevent adverse events and frequent assessment of treatment indicators. Boosting primary studies in this area is essential, since few studies on the subject have been identified in the present review.