Journal of Nephrology

, Volume 32, Issue 1, pp 51–56 | Cite as

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

  • Muhammad Masoom JavaidEmail author
  • Behram Ali Khan
  • Srinivas Subramanian


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.


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


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
    Email author
  • 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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