RESUMO
Incremental peritoneal dialysis (PD) is characterized as less than a "standard dose" PD prescription. Compared to standard treatment, it has many potential advantages, including better preservation of residual renal function, a lower risk of peritonitis, and a decreased care delivery burden while reducing the environmental impact and economic cost. Unplanned PD can be defined when treatment starts up to 14 days after catheter insertion and is recognized as a safe and feasible clinical approach. In this perspective paper, we briefly discuss both strategies and share our experience and clinical routine in managing incremental PD after unplanned initiation.
RESUMO
This study aimed to investigate the clinical characteristics, prognosis, and factors for survival of patients who underwent early-start peritoneal dialysis (PD) within 24 h after catheter insertion three years after PD. This study was conducted from January 1, 2013 to December 31, 2017. All adult patients who were diagnosed with end-stage renal disease (ESRD) and underwent PD for the first time within 24 h after catheter insertion in our hospital were included. All patients with PD were followed-up until they withdrew from PD, switching to hemodialysis, were transferred to other medical centers, underwent renal transplantation, died or were lost to follow-up, or continued to undergo dialysis until the end of the study period. The follow-up observation lasted three years. The number of eligible patients was 110, and switching to hemodialysis and death were the main reasons for patients to withdraw from PD. The 1-, 2-, and 3-year technical survival rates of patients were 89.1, 79.1, and 79.1% respectively, while the 1-, 2- and 3-year survival rates were 90, 81.8, and 81.8%, respectively. The Charlson comorbidity index, age, hemoglobin, serum albumin, diabetic nephropathy, chronic glomerulonephritis, and hypertensive renal damage were independent risk factors that affected the prognosis of PD patients. Under the condition of ensuring the quality of the PD catheter insertion, early-start PD within 24 h after catheter insertion is a safe treatment approach for ESRD patients.
