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Comparison of immediate-start peritoneal dialysis without break-in period and conventional-start peritoneal dialysis: a two-center retrospective audit

  • Nephrology - Original Paper
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Abstract

Purpose

Immediate-start peritoneal dialysis (PD) has emerged as a strategy for patients in need of urgent dialysis. However, the ideal timing for initiating this procedure remains uncertain. In this study, we aimed to compare complications and outcomes between immediate-start PD and conventional-start PD.

Methods

We performed a two-center retrospective cohort study between 1 January 2015 and 31 May 2020. Patients who underwent PD were divided into immediate-start PD (without break-in period) and conventional-start PD group (break-in period within at least 14 days). The primary outcomes were the incidence of the mechanical complications and infectious complication. The secondary outcomes were technique failure and patient survival.

Results

A total of 209 patients (106 in the immediate-start PD group and 103 in the conventional-start PD group) were included. Immediate-start PD had significantly lower catheter malfunction or migration rate compare with conventional-start PD (2.8% vs. 15.5%, p = 0.003) but comparable rates of dialysate leaks, pleuroperitoneal leaks, and hemoperitoneum. Infectious complications (exit-site infection and peritonitis) were similar between groups. Technique survival was comparable (7.5% vs. 4.8%, p = 0.22), while immediate-start PD exhibited lower mortality rates (0.9% vs. 13.6%, p = 0.001).

Conclusion

Immediate-start PD appears to be a viable option for patients in need of urgent dialysis, with reduced catheter complications and comparable infectious complications and technique survival when compared to conventional-start PD.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors received financial support for the research by The Kidney Foundation of Thailand.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanit Road, Hat Yai, 90110, Songkhla, Thailand

    Suwikran Wongpraphairot & Atthaphong Phongphithakchai

  2. Suratthanee Hospital, Surat Thani, Thailand

    Kitjapong Choopun, Tharinee Sriphatphiriyakun & Apiradee Titawatanakul

  3. Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand

    Virasakdi Chongsuvivatwong

Authors
  1. Suwikran Wongpraphairot
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  2. Kitjapong Choopun
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  3. Tharinee Sriphatphiriyakun
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  4. Apiradee Titawatanakul
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  5. Virasakdi Chongsuvivatwong
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  6. Atthaphong Phongphithakchai
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Contributions

SW, KC and AP were included in preparing the concept and design. KC, TS, and AT collected data. VC performed data analysis. SW, KC and AP draft the first article. All authors participated in preparing the final draft of the manuscript, revised the manuscript and critically for important intellectual contents. All authors have read and approved the content of the manuscript to be published.

Corresponding author

Correspondence to Atthaphong Phongphithakchai.

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Conflict of interest

The authors declared that there are no competing interests.

Ethical approval

The research followed the tenets of the 1964 Declaration of Helsinki. The Human Research Ethics Committee of the faculty of medicine, Prince of Songkla University approved the study with the code number of REC.63-337-14-3 and Suratthani hospital with the code number of REC 64-001.

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Wongpraphairot, S., Choopun, K., Sriphatphiriyakun, T. et al. Comparison of immediate-start peritoneal dialysis without break-in period and conventional-start peritoneal dialysis: a two-center retrospective audit. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03967-0

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  • DOI: https://doi.org/10.1007/s11255-024-03967-0

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