Botucatu School of Medicine, UNESP, Botucatu, Brazil.
Clinical Hospital from Botucatu Medical School, Botucatu, Brazil.
Blood Purif. 2020;49(6):652-657. doi: 10.1159/000506505. Epub 2020 Mar 6.
Chronic kidney disease is a significant problem of public health worldwide, and up to 60% of patients start dialysis in an unplanned manner without a definitive dialysis access. Recently, peritoneal dialysis (PD) has emerged as an alternative to unplanned chronic dialytic method, and the world collective experience shows that PD can be an efficient, safe, and cost-effective alternative with comparable outcomes to the planned PD and urgent-start hemodialysis (HD). More importantly, as compared to urgent-start HD using a central venous catheter, urgent-start PD has significantly fewer incidences of catheter-related bloodstream infections, dialysis-related mechanical complications, and need for dialysis catheter reinsertions during the initial time of the therapy. An integrative review was conducted on PD urgent start compared to HD urgent start and to planned PD, identifying its potential advantages and limitations. Literature search was performed within multiple databases, and observational studies on clinical experience with urgent PD were reviewed and appraised.
慢性肾脏病是一个全球性的重大公共卫生问题，多达 60%的患者在没有明确透析通路的情况下无计划地开始透析。最近，腹膜透析（PD）已成为一种替代无计划慢性透析方法的选择，全球经验表明 PD 可以是一种高效、安全且具有成本效益的替代方法，其结果与计划 PD 和紧急开始血液透析（HD）相当。更重要的是，与使用中心静脉导管的紧急开始 HD 相比，紧急开始 PD 发生导管相关血流感染、透析相关机械并发症以及在治疗初始阶段需要重新插入透析导管的情况明显更少。对 PD 紧急开始与 HD 紧急开始和计划 PD 进行了综合审查，确定了其潜在的优势和局限性。在多个数据库中进行了文献检索，并对紧急 PD 的临床经验观察研究进行了回顾和评估。
