A protocol for urgent-start peritoneal dialysis results in less blood stream infections and appears to reduce mortality when compared to urgent-start hemodialysis, according to research presented at the National Kidney Foundation’s 2015 Spring Clinical Meetings in Dallas, TX.
Most patients who present with end-stage renal disease in the emergency room are given urgent-start hemodialysis with a central venous catheter. But Keck Medicine of USC researchers hypothesized that allowing patients the option of starting with peritoneal dialysis (PD) could improve long-range outcomes.
“In general, the overall outcomes for urgent-start PD patients are no different than patients who start planned PD or planned hemodialysis (HD)” said lead researcher Arshia Ghaffari, DO, assistant clinical professor of medicine in nephrology. “We were also pleased to see we didn’t see a higher rate of complications, such as peritonitis, that we thought we might have in these urgent-start PD patients.”
The research is based on 161 dialysis patients, of which 46 were urgent-start PD patients.
Those who had urgent-start hemodialysis with a central venous catheter had a 43 percent higher hospitalization rate, 4 times higher adjusted rate of catheter-related bacteremia, and 66 percent higher number of dialysis access procedures compared to urgent-start PD patients.
Urgent-start PD patients had a lower rate of mortality and technique failure as well.