Daniela Ponce
Botucatu School of Medicine, Brazil
Title: Urgent Start Peritoneal Dialysis: a viable option for acute and chronic kidney failure
Biography
Biography: Daniela Ponce
Abstract
Peritoneal dialysis (PD) may be a feasible, safe and complementary alternative to hemodialyis (HD) not only in the chronic, but also in the acute setting. Recently, interest in using PD to manage acute kidney injury (AKI) patients has been increasing. The Brazilian studies have shown that, with careful thought and planning, critically ill patients can be successfully treated by PD. To overcome some of the classic limitations of PD use in AKI, such as a high chance of infectious and mechanical complications and no metabolic control, they have proposed the use of cycles, flexible catheter, and a high volume of dialysis fluid. This knowledge can be used in the concept of unplanned start on chronic PD and may be a tool to increase the PD penetration rate among incident patients starting chronic dialysis therapy. Although data on unplanned initiation of chronic PD are scarce, they indicate that mortality is the same or even better than for unplanned initiation of HD and the number of infectious complications seems to be lower. In conclusion, unplanned PD is an option and should be offered in an unbiased way to all patients without contraindications to starting urgent PD and it should be offered in an unbiased way to all patients without contraindications to PD starting unplanned dialysis.