McQuillan Rory F, Lok Charmaine E
Division of Nephrology, Department of Medicine, University Health Network and The University of Toronto, Toronto, Ontario, Canada.
Semin Dial. 2018 Jul;31(4):325-331. doi: 10.1111/sdi.12700. Epub 2018 Apr 19.
Despite its many positive attributes, peritoneal dialysis remains underutilized, particularly in the United States. Urgent-start peritoneal dialysis (PD) has been proposed as a method of increasing PD prevalence. Urgent-start PD has been shown to be safe, feasible, and effective. However, urgent-start PD is also accompanied by several multidimensional challenges. This article is intended to equip the reader with a practical sense of whether an urgent-start PD program would be appropriate in his or her own clinical context and if appropriate, what factors would be necessary for such a program to flourish. As such, we summarize latent factors, which are necessary to consider before instituting an urgent-start PD. Then, using a series of clinical vignettes, highlight the component parts of a successful urgent-start PD program and the patient population who stand to benefit most from this strategy. The discussion is then balanced by presenting limitations to consider in the urgent-start PD approach.
尽管腹膜透析有诸多积极特性，但它的利用率仍然较低，在美国尤其如此。紧急启动腹膜透析（PD）已被提议作为提高腹膜透析普及率的一种方法。紧急启动腹膜透析已被证明是安全、可行且有效的。然而，紧急启动腹膜透析也伴随着几个多方面的挑战。本文旨在让读者切实了解在其自身临床环境中紧急启动腹膜透析计划是否合适，以及如果合适，这样一个计划蓬勃发展需要哪些因素。因此，我们总结了在实施紧急启动腹膜透析之前需要考虑的潜在因素。然后，通过一系列临床案例，突出成功的紧急启动腹膜透析计划的组成部分以及最能从该策略中受益的患者群体。随后通过介绍紧急启动腹膜透析方法中需要考虑的局限性来平衡讨论。
