scholarly journals Urgent-start peritoneal dialysis for end-stage renal disease patients: literature review and worldwide evidence-based practice

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atthaphong Phongphithakchai ◽  
Phongsak Dandecha ◽  
Sukit Raksasuk ◽  
Thatsaphan Srithongkul
Keyword(s):  
Peritoneal Dialysis ◽  
Central Venous Catheter ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Venous Catheter ◽  
Central Venous ◽  
Dialysis Therapy ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

AbstractThe prevalence of end-stage renal disease (ESRD) is on the rise worldwide. Meanwhile, the number of older people requiring dialysis therapy is increasing as a result of this population. We found that starting dialysis in an unplanned manner is a common occurrence, even for patients with nephrology follow-up. Most centers choose hemodialysis with a high rate of central venous catheter use at the time of initiation of dialysis. Current data has found that central venous catheter use is independently associated with increased mortality and high bacteremia rates. Peritoneal dialysis is one option to avoid bacteremia. The International Society for Peritoneal Dialysis guidelines suggests a break-in period of at least two weeks prior to an elective start of peritoneal dialysis, without mentioning urgent-start peritoneal dialysis. For unplanned ESRD patients, it is unrealistic to wait for two weeks before initiating peritoneal dialysis therapy. Urgent-start peritoneal dialysis has been suggested to be a practical approach of prompt initiation of peritoneal dialysis after catheter insertion, which may avoid an increased risk of central venous catheter-related complications, including bacteremia, central venous stenosis, and thrombosis associated with the temporary use of hemodialysis. Peritoneal dialysis is the alternative option, and many studies have presented an interest in urgent-start peritoneal dialysis. Some reports have compared urgent-start hemodialysis to peritoneal dialysis and found that urgent-start peritoneal dialysis is a safe and effective alternative to hemodialysis for an unplanned dialysis patient. This review aims to compare each literature report regarding techniques, prescriptions, outcomes, complications, and costs of urgent-start peritoneal dialysis.

American Association of Kidney Patients survey of patient preferences for hemodialysis vascular access

2019 ◽  
Vol 21 (2) ◽  
pp. 230-236
Author(s):  
Saravanan Balamuthusamy ◽  
Larry E Miller ◽  
Diana Clynes ◽  
Erin Kahle ◽  
Richard A Knight ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
American Association ◽  
Venous Catheter ◽  
Central Venous ◽  
Stage Renal Disease ◽  
End Stage

Objectives: To determine the vascular access modalities used for hemodialysis, the reasons for choosing them, and determinants of satisfaction with vascular access among patients with end-stage renal disease. Methods: The American Association of Kidney Patients Center for Patient Research and Education used the American Association of Kidney Patients patient engagement database to identify eligible adult hemodialysis patients. Participants completed an online survey consisting of 34 demographic, medical history, and hemodialysis history questions to determine which vascular access modalities were preferred and the reasons for these preferences. Results: Among 150 respondents (mean age 54 years, 53% females), hemodialysis was most frequently initiated with central venous catheter (64%) while the most common currently used vascular access was arteriovenous fistula (66%). Most (86%) patients previously received an arteriovenous fistula, among whom 77% currently used the arteriovenous fistula for vascular access. Older patients and males were more likely to initiate hemodialysis with an arteriovenous fistula. The factors most frequently reported as important in influencing the selection of vascular access modality included infection risk (87%), physician recommendation (84%), vascular access durability (78%), risk of complications involving surgery (76%), and impact on daily activities (73%); these factors were influenced by patient age, sex, and race. Satisfaction with current vascular access was 90% with arteriovenous fistula, 79% with arteriovenous graft, and 67% with central venous catheter. Conclusion: Most end-stage renal disease patients continue to initiate hemodialysis with central venous catheter despite being associated with the lowest satisfaction rates. While arteriovenous fistula was associated with the highest satisfaction rate, there are significant barriers to adoption that vary based on patient demographics and perception of procedure invasiveness.

scholarly journals Unplanned Start on Peritoneal Dialysis Right after Pd Catheter Implantation for Older People with End-Stage Renal Disease

2015 ◽  
Vol 35 (6) ◽  
pp. 622-624 ◽  
Author(s):  
Johan V. Povlsen ◽  
Anette Bagger Sørensen ◽  
Per Ivarsen
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Older People ◽  
End Stage Renal Disease ◽  
Central Venous ◽  
Increased Risk ◽  
Catheter Implantation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Unplanned Start

Unplanned start on dialysis remains a major problem for the dialysis community worldwide. Late-referred patients with end-stage renal disease (ESRD) and urgent need for dialysis are overrepresented among older people. These patients are particularly likely to be started on in-center hemodialysis (HD), with a temporary vascular access known to be associated with excess mortality and increased risks of potentially lethal complications such as bacteremia and central venous thrombosis or stenosis. The present paper describes in detail our program for unplanned start on automated peritoneal dialysis (APD) right after PD catheter implantation and summarizes our experiences with the program so far. Compared with planned start on PD after at least 2 weeks of break-in between PD catheter implantation and initiation of dialysis, unplanned start may be associated with a slight increased risk of mechanical complications but apparently no detrimental effect on mortality, peritonitis-free survival, or PD technique survival. In our opinion and experience, the risk of serious complications associated with the implantation and immediate use of a PD catheter is less than the risk of complications associated with unplanned start on HD with a temporary central venous catheter (CVC). Unplanned start on APD is a gentle, safe, and feasible alternative to unplanned start on HD with a temporary CVC that is also valid for the late-referred older patient with ESRD and urgent need for dialysis.

Dialysis access: issues related to conversion from peritoneal dialysis to hemodialysis and vice versa

2017 ◽  
Vol 18 (1_suppl) ◽  
pp. S41-S46 ◽  
Author(s):  
Maurizio Gallieni ◽  
Antonino Giordano ◽  
Anna Ricchiuto ◽  
Davide Gobatti ◽  
Maurizio Cariati
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Venous Catheter ◽  
Infectious Complications ◽  
Dialysis Access ◽  
Central Venous ◽  
Treatment Start ◽  
Alternative Approach ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined. Creating backup fistulas at the time of PD treatment start to allow emergency access for HD has proved to be inefficient, but it may be considered in patients with progressive difficulty in achieving adequate depuration and/or peritoneal ultrafiltration. A big challenge is represented by patients switching from PD to HD for unexpected infectious complications. Those patients need to start HD with a central venous catheter (CVC), but an alternative approach might be using an early cannulation graft, provided that infection has been cleared by the circulation. An early cannulation graft might also be used to considerably shorten the time spent using a CVC. In patients who need a conversion from HD to PD, urgent-start PD is now an accepted and well-established approach.

Comparison of the characteristics of patients with invasive infections and noninvasive infections caused by Trichosporon asahii

2020 ◽  
Author(s):  
Jinyeong Kim ◽  
Min Jae Kim ◽  
Yong Pil Chong ◽  
Sung-Han Kim ◽  
Sang-Ho Choi ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
End Stage Renal Disease ◽  
Hematologic Malignancy ◽  
Venous Catheter ◽  
Invasive Infection ◽  
Central Venous ◽  
Trichosporon Asahii ◽  
Invasive Infections ◽  
Stage Renal Disease ◽  
End Stage

Abstract We performed retrospective study to identify the characteristics of invasive Trichosporon asahii infection. A total of 102 patients with T. asahii were identified including 18 (18%) with invasive infection. Invasive infection was associated with indwelling central venous catheter (94% vs 54%, P = .001), prior antifungal agent use (50% vs 18%, P = .01), hematologic malignancy (33% vs 7%, P = .006), and end-stage renal disease (28% vs 7%, P = .02). Patients with invasive infections had higher in-hospital mortality than patients with noninvasive infections (61% vs 27%, P = .006). Those with the above risk factors should be monitored for the development of invasive T. asahii infection. Lay summary Patients with indwelling central venous catheter, prior antifungal agent use, hematologic malignancy, and end-stage renal disease were associated with invasive Trichosporon asahii infection. Patients with invasive infections had higher in-hospital mortality than patients without invasive infection.

scholarly journals PUK8 COST EFFECTIVENESS OF ICODEXTRINE-BASED SOLUTIONS IN END STAGE RENAL DISEASE PATIENTS UNDERGOING PERITONEAL DIALYSIS THERAPY

2007 ◽  
Vol 10 (3) ◽  
pp. A104
Author(s):  
F Garcia-Contreras ◽  
P Constantino-Casas ◽  
I Prieto-Arenas ◽  
D Amato ◽  
JC Blackburn ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cost Effectiveness ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Therapy ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Dialysis-Associated Telangiectasia: Case Report and Review of the Literature

2016 ◽  
Vol 36 (1) ◽  
pp. 104-105 ◽  
Author(s):  
Yassar Alamri ◽  
James Tietjens ◽  
Christopher Wakeman
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Review Of The Literature ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

Patients with end-stage renal disease (ESRD) are at an increased risk of bleeding. We report the case of a 40-year-old female, on peritoneal dialysis for ESRD, who presented with profound anemia; she was later found to have a bleeding jejunal dialysis-associated telangiectasia. We review the literature published to date on dialysis-associated telangiectasia and discuss the possible underling etiologies.

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