Effectiveness of peritoneal dialysis initiation using Short-term Peritoneal dialysis Induction and Education (SPIED) technique

Background and objectivesBioelectrical impedance analysis (BIA) devices can help assess volume overload in patients receiving maintenance peritoneal dialysis. However, the effects of BIA on the short-term hard end points of peritoneal dialysis lack consistency. This study aimed to test whether BIA-guided fluid management could improve short-term outcomes in patients on peritoneal dialysis.Design, setting, participants, & measurementsA single-center, open-labeled, randomized, controlled trial was conducted. Patients on prevalent peritoneal dialysis with volume overload were recruited from July 1, 2013 to March 30, 2014 and followed for 1 year in the initial protocol. All participants with volume overload were 1:1 randomized to the BIA-guided arm (BIA and traditional clinical methods) and control arm (only traditional clinical methods). The primary end point was all-cause mortality and secondary end points were cardiovascular disease mortality and technique survival.ResultsA total of 240 patients (mean age, 49 years; men, 51%; diabetic, 21%, 120 per group) were enrolled. After 1-year follow-up, 11(5%) patients died (three in BIA versus eight in control) and 21 patients were permanently transferred to hemodialysis (eight in BIA versus 13 in control). The rate of extracellular water/total body water decline in the BIA group was significantly higher than that in the control group. The 1-year patient survival rates were 96% and 92% in BIA and control groups, respectively. No significant statistical differences were found between patients randomized to the BIA-guided or control arm in terms of patient survival, cardiovascular disease mortality, and technique survival (P>0.05).ConclusionsAlthough BIA-guided fluid management improved the fluid overload status better than the traditional clinical method, no significant effect was found on 1-year patient survival and technique survival in patients on peritoneal dialysis.

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Peritoneal Dialysis First: PD Should Be Considered for Dialysis Initiation

Nephrology Times ◽

10.1097/01.nep.0000352294.48155.93 ◽

2009 ◽

Vol 2 (5) ◽

pp. 6-7

Author(s):

J Kevin Tucker ◽

Bradley M. Denker

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Initiation

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Sustained Increase in Peritoneal Dialysis Prevalence through a Structured PD Initiation Service

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00261 ◽

2018 ◽

Vol 38 (5) ◽

pp. 374-376 ◽

Cited By ~ 1

Author(s):

Muhammad Masoom Javaid ◽

Behram Ali Khan ◽

Emily Xe Yeo ◽

Boon Wee Teo ◽

Srinivas Subramanian

Keyword(s):

Peritoneal Dialysis ◽

Rapid Expansion ◽

Dialysis Initiation ◽

Coordinated Care ◽

Timely Initiation ◽

Initiation Of Dialysis ◽

Patient Selection Criteria ◽

Dedicated Team ◽

Sustained Increase

A structured peritoneal dialysis (PD) initiation service provided by a dedicated team of nephrologists, interventionists, and PD nurses, taking patients through the stages of predialysis education and monitoring, dialysis catheter insertion, dialysis initiation, and follow-up in the immediate post-dialysis initiation period, can go a long way in expanding PD prevalence. The authors noticed a rapid expansion of their PD program following the introduction of such a service, and they share their experience in this article. A multidisciplinary team providing 1-stop coordinated care may help in alleviating the differences in patient selection criteria, minimize delays in PD catheter insertions, ensure timely initiation of dialysis, reduce the need to start dialysis urgently, actively identify and sort any teething issues, enhance patients’ confidence, and reduce technique failures.

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Nierenersatzverfahren: Information, Aufklärung, Dokumentation

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0549-9578 ◽

2018 ◽

Vol 143 (12) ◽

pp. 863-870

Author(s):

Jan Galle ◽

Jana Reitlinger

Keyword(s):

Peritoneal Dialysis ◽

Kidney Transplantation ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Donation ◽

Living Donation ◽

Short Term ◽

Donor Kidney ◽

Kidney Replacement Therapy ◽

Caring Environment

AbstractIn renal replacement therapy, different methods are available: hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx). In addition, variants can be used: HD as a home HD or center HD, PD as a conventional PD or automated (cycler) PD, KTx as a potentially short-term predictable living donation or conventional donor kidney donation. The patient and his familiar or caring environment must be informed accordingly. This means first of all: information about which procedures of kidney replacement therapy are possible and can be offered. Then the specific risks associated with each procedure should be elucidated (e. g. HD and shunt bleeding, PD and peritonitis, KTx and infections/neoplasias). This necessarily includes a structured documentation of the educating center/doctor about the communicated information and decisions taken.

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