医学
腹膜透析
血液透析
重症监护医学
透析
中心静脉导管
观察研究
随机对照试验
肾脏替代疗法
导管
家庭血液透析
菌血症
外科
内科学
抗生素
微生物学
生物
作者
Matthew Tunbridge,Yeoungjee Cho,David W. Johnson
出处
期刊:Current Opinion in Nephrology and Hypertension
[Ovid Technologies (Wolters Kluwer)]
日期:2019-11-01
卷期号:28 (6): 631-640
被引量:18
标识
DOI:10.1097/mnh.0000000000000545
摘要
Purpose of review This review aims to provide an up-to-date summary of the definition, current practice and evidence regarding the role of urgent-start peritoneal dialysis (USPD) in patients with end-stage kidney disease who present with unplanned dialysis requirement without functional access. Recent findings USPD can be broadly defined as peritoneal dialysis initiation within the first 2 weeks after catheter insertion. Published practice patterns, in terms of catheter insertion approach, peritoneal dialysis initiation time or initial fill volume, are highly variable. Most evidence comes from small, retrospective, single-center observational studies and only one randomized controlled trial. Compared with conventional-start peritoneal dialysis, USPD appears to moderately increase the risk of mechanical complications, such as dialysate leak (relative risk 3.21, 95% confidence interval 1.73–5.95), but does not appear to adversely affect technique or patient survival. USPD may also reduce the risk of bacteremia compared with urgent-start hemodialysis delivered by central venous catheter (CVC). Summary USPD represents an important opportunity to establish patients with urgent, unplanned dialysis requirements on a cost-effective, home-based dialysis modality with lower serious infection risks than the alternative option of hemodialysis via CVC. Robust, well executed trials are required to better inform optimal practice and safeguard patient-centered and patient-reported outcomes.
科研通智能强力驱动
Strongly Powered by AbleSci AI