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      Peritoneal Dialysis as an Urgent-Start Option for Incident Patients on Chronic Renal Replacement Therapy: World Experience and Review of Literature


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          Chronic kidney disease is a significant problem of public health worldwide, and up to 60% of patients start dialysis in an unplanned manner without a definitive dialysis access. Recently, peritoneal dialysis (PD) has emerged as an alternative to unplanned chronic dialytic method, and the world collective experience shows that PD can be an efficient, safe, and cost-effective alternative with comparable outcomes to the planned PD and urgent-start hemodialysis (HD). More importantly, as compared to urgent-start HD using a central venous catheter, urgent-start PD has significantly fewer incidences of catheter-related bloodstream infections, dialysis-related mechanical complications, and need for dialysis catheter reinsertions during the initial time of the therapy. An integrative review was conducted on PD urgent start compared to HD urgent start and to planned PD, identifying its potential advantages and limitations. Literature search was performed within multiple databases, and observational studies on clinical experience with urgent PD were reviewed and appraised.

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          Author and article information

          Blood Purif
          Blood Purification
          S. Karger AG
          November 2020
          06 March 2020
          : 49
          : 6
          : 652-657
          [_a] aBotucatu School of Medicine, UNESP, Botucatu, Brazil
          [_b] bClinical Hospital from Botucatu Medical School, Botucatu, Brazil
          Author notes
          *Daniela Ponce, Avenue Alameda das Hortências, 823 Parque das Cascatas, Botucatu 18607390 (Brazil), E-Mail daniela.ponce@unesp.br or dponce@fmb.unesp.br
          506505 Blood Purif 2020;49:652–657
          © 2020 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 31 July 2019
          : 13 February 2020
          Page count
          Figures: 1, Tables: 1, Pages: 6

          Cardiovascular Medicine,Nephrology
          Mortality,Urgent start,Hemodialysis,Peritoneal dialysis,Chronic kidney disease


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