Outcomes of early-start peritoneal dialysis (PD) and the comparison with urgent-start hemodialysis and conventional-start PD.

BACKGROUND: Limited data in the literature is comparing early-start peritoneal dialysis (PD), urgent-start hemodialysis (HD) with the jugular central venous catheter (CVC), and conventional-start PD. METHODS: This retrospective study was conducted with 148 patients with early-start PD, 104 patients with conventional-start PD, and 100 patients with urgent-start HD. Early-start PD was defined as catheter break-in time between 3 and 14 days. RESULTS: The occurrence of dialysate-leakage was similar between PD groups (p = 0.1). Bleeding at the catheter site was detected in 8 (2.3%) patients with CVC. There was no significant difference in catheter dysfunction and revision. PD groups had statistically similar peritonitis rates (p = 0.5). 19% (19/100) of patients suffered CVC-related bloodstream infection and one patient died due to septic shock. Technique survival was significantly higher at early-start PD than the conventional-start PD at 6 months (p = 0.02). CONCLUSION: Initiating early-start PD is comparable with conventional-start PD, and it may be an alternative dialysis modality to avoid bloodstream infections in suitable patients.