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

  • Muhammad Masoom Javaid
  • Behram Ali Khan
  • Srinivas Subramanian
Review

Abstract

Late-presenting end-stage renal disease is a significant problem worldwide. Up to 70% of patients start dialysis in an unplanned manner without a definitive dialysis access in place. Haemodialysis via a central venous catheter is the default modality for the majority of such patients, and peritoneal dialysis is usually not considered as a feasible option. However, in the recent years, some reports on urgent-start peritoneal dialysis in the late-presenting end-stage renal disease have been published. The collective experience shows that PD can be a safe, efficient and cost-effective alternative to haemodialysis in late-presenting end-stage renal disease with comparable outcomes to the conventional peritoneal dialysis and urgent-start haemodialysis. More importantly, as compared to urgent-start haemodialysis via a central venous catheter, urgent-start peritoneal dialysis has significantly fewer incidences of catheter-related bloodstream infections, dialysis-related complications and need for dialysis catheter re-insertions during the initial phase of the therapy. This article examines the rationale and feasibility for starting peritoneal dialysis urgently in late-presenting end-stage renal disease patients and reviews the literature to compare the urgent-start peritoneal dialysis with conventional peritoneal dialysis and urgent-start haemodialysis.

Keywords

End-stage renal disease Haemodialysis Peritoneal dialysis Urgent start Unplanned start 

Notes

Compliance with ethical standards

Conflict of interest

No conflict of interest declared.

Ethical approval

Not applicable.

Informed consent

Not applicable.

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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  • Muhammad Masoom Javaid
    • 3
  • Behram Ali Khan
    • 1
    • 2
  • Srinivas Subramanian
    • 1
    • 2
  1. 1.Division of Nephrology, University Medicine ClusterNational University Hospital SingaporeSingaporeSingapore
  2. 2.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  3. 3.Mildura Base HospitalMilduraAustralia

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