Low-Volume Tidal Peritoneal Dialysis Is a Preferable Mode in Patients Initiating Urgent-Start Automated Peritoneal Dialysis: A Randomized, Open-Label, Prospective Control Study.

The aim of this study is to evaluate the safety of low-volume tidal peritoneal dialysis (TPD) and intermittent peritoneal dialysis (IPD) in ESRD patients initiating automated peritoneal dialysis (APD) after an acute catheter insertion. Clinical outcomes of patients who received either TPD or IPD using an APD system were compared in a randomized, open-label, prospective control study in a single-center setting. From May 2011 to May 2013, 49 patients were enrolled and 27 patients received low-volume TPD treatment, whereas 22 patients underwent low-volume IPD right after Tenckhoff catheter insertion. The incidence of complications during the 14-day APD treatment were observed. After APD treatment, all the patients were transferred to continuous ambulatory peritoneal dialysis and followed up for 2 years. The IPD group demonstrated a significantly higher incidence of catheter-related complications (omental wrapping 27.3% vs. 0% and suction pain 18.2% vs. 0%) than the TPD group after adjusting for age, gender, baseline diabetes, systolic blood pressure, BMI, and the experience of the operators. However, the short duration of APD treatment with either IPD or TPD mode did not affect the long-time technical survival. In patients immediately after catheter insertion, low-volume TPD mode demonstrated a lower incidence of catheter-related complications compared to IPD. Although our results provided evidence that TPD is a preferable APD mode for this specific population, definitive conclusions about TPD benefit cannot be made, owing to early termination of the trial.