Data from: Urgent-start peritoneal dialysis and hemodialysis in ESRD patients: complications and outcomes

Background: Several studies have suggested that urgent-start peritoneal
dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients
with end-stage renal disease (ESRD), but the impact of the dialysis
modality on outcome, especially on short-term complications, in
urgent-start dialysis has not been directly evaluated. The aim of the
current study was to compare the complications and outcomes of PD and HD
in urgent-start dialysis ESRD patients. Methods: In this retrospective
study, ESRD patients who initiated dialysis urgently without a
pre-established functional vascular access or PD catheter at a single
center from January 2013 to December 2014 were included. Patients were
grouped according to their dialysis modality (PD and HD). Each patient was
followed for at least 30 days after catheter insertion (until January
2016). Dialysis-related complications and patient survival were compared
between the two groups. Results: Our study enrolled 178 patients (56.2%
male), of whom 96 and 82 patients were in the PD and HD groups,
respectively. Compared with HD patients, PD patients had more
cardiovascular disease, less heart failure, higher levels of serum
potassium, hemoglobin, serum albumin, serum pre-albumin, and lower levels
of brain natriuretic peptide. There were no significant differences in
gender, age, use of steroids, early referral to a nephrologist, prevalence
of primary renal diseases, prevalence of co-morbidities, and other
laboratory characteristics between the groups. The incidence of
dialysis-related complications during the first 30 days was significantly
higher in HD than PD patients. HD patients had a significantly higher
probability of bacteremia compared to PD patients. HD was an independent
predictor of short-term (30-day) dialysis-related complications. There was
no significant difference between PD and HD patients with respect to
patient survival rate. Conclusion: In an experienced center, PD is a safe
and feasible dialysis alternative to HD for ESRD patients with an urgent
need for dialysis.