Daniela Ponce1,2, Alexandre Minetto Brabo1, André Luís Balbi1. 1. UNESP - Botucatu School of Medicine, University Sao Paulo State. 2. USP - Dentistry College of Bauru, Course of Medicine, Bauru, São Paulo State, Brazil.
Abstract
PURPOSE OF REVIEW: Although historically peritoneal dialysis was widely used in nephrology, it has been underutilized in recent years. In this review, we present several key opportunities and strategies for revitalization of urgent start peritoneal dialysis use, and discuss the recent literature on clinical experience with peritoneal dialysis use in the acute and unplanned setting. RECENT FINDINGS: Interest in using urgent start peritoneal dialysis to manage acute kidney injury (AKI) and unplanned chronic kidney disease (CKD) stage 5 patients has been increasing. To overcome some of the classic limitations of peritoneal dialysis use in AKI, such as a high chance of infectious and mechanical complications, and no control of urea, the use of cycles, flexible catheters, and a high volume of dialysis fluid has been proposed. This knowledge can be used in the case of an unplanned start on chronic peritoneal dialysis, and may be a tool to increase the peritoneal dialysis penetration rate among incident patients starting chronic dialysis therapy. SUMMARY: Peritoneal dialysis should be offered in an unbiased way to all patients starting unplanned dialysis, and without contraindications to peritoneal dialysis. It may be a feasible, well tolerated, and complementary alternative to hemodialysis, not only in the chronic setting, but also in the acute.
PURPOSE OF REVIEW: Although historically peritoneal dialysis was widely used in nephrology, it has been underutilized in recent years. In this review, we present several key opportunities and strategies for revitalization of urgent start peritoneal dialysis use, and discuss the recent literature on clinical experience with peritoneal dialysis use in the acute and unplanned setting. RECENT FINDINGS: Interest in using urgent start peritoneal dialysis to manage acute kidney injury (AKI) and unplanned chronic kidney disease (CKD) stage 5 patients has been increasing. To overcome some of the classic limitations of peritoneal dialysis use in AKI, such as a high chance of infectious and mechanical complications, and no control of urea, the use of cycles, flexible catheters, and a high volume of dialysis fluid has been proposed. This knowledge can be used in the case of an unplanned start on chronic peritoneal dialysis, and may be a tool to increase the peritoneal dialysis penetration rate among incident patients starting chronic dialysis therapy. SUMMARY: Peritoneal dialysis should be offered in an unbiased way to all patients starting unplanned dialysis, and without contraindications to peritoneal dialysis. It may be a feasible, well tolerated, and complementary alternative to hemodialysis, not only in the chronic setting, but also in the acute.
Authors: José L Hernández-Castillo; Joana Balderas-Juárez; Omar Jiménez-Zarazúa; Karen Guerrero-Toriz; Michelle P Loeza-Uribe; Erika K Tenorio-Aguirre; Jesús G Mendoza-García; Jaime D Mondragón Journal: Kidney Int Rep Date: 2020-07-26
Authors: Elaine Bowes; Jennifer Joslin; Dandisonba C B Braide-Azikiwe; Caroline Tulley; Kate Bramham; Sujit Saha; Satish Jayawardene; Babakang Shakoane; C Jason Wilkins; Sam Hutchings; Philip Hopkins; Eirini Lioudaki; Catriona Shaw; Hugh Cairns; Claire C Sharpe Journal: Kidney Int Rep Date: 2020-12-11
Authors: Delin Wang; Nathan Calabro-Kailukaitis; Mahmoud Mowafy; Eric S Kerns; Khetisuda Suvarnasuddhi; Jonah Licht; Sun H Ahn; Susie L Hu Journal: Clin Kidney J Date: 2019-05-23