Feasibility of a break-in period of less than 24 hours for urgent start peritoneal dialysis: a multicenter study

• Published in: Renal Failure
• Main Authors: Xi Wen, Liming Yang, Zhanshan Sun, Xiaoxuan Zhang, Xueyan Zhu, Wenhua Zhou, Xiaoqing Hu, Shichen Liu, Ping Luo, Wenpeng Cui
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2022-12-01
• Subjects: Urgent start peritoneal dialysis; peritoneal dialysis; break-in period; complications; technique failure
• Online Access: https://www.tandfonline.com/doi/10.1080/0886022X.2022.2049306
• ISSN: 0886-022X; 1525-6049

Purpose Urgent start peritoneal dialysis (USPD) is an effective therapeutic method for end-stage renal disease (ESRD). However, whether it is safe to initiate peritoneal dialysis (PD) within 24 h unclear. We examined the short-term outcomes of a break-in period (BI) of 24 h for patients undergoing USPD.Methods This real-world, multicenter, retrospective cohort study evaluated USPD patients from five centers from January 2013 to August 2020. Patients were divided into BI ≤ 24 h or BI > 24 h groups. The Primary outcomes included incidence of mechanical and infectious complications. The secondary outcome was technique failure. Moreover, we presented a subgroup analysis for patients who did not receive temporary hemodialysis (HD).Results A total of 871 USPD patients were included: 470 in the BI ≤ 24 h and 401 in the BI > 24 h groups. Mechanical and infectious complications did not differ between the two groups across the follow-up timepoints (2 weeks, 1 month, 3 months, and 6 months) (p > 0.05). Multiple logistic regression analysis revealed that BI ≤ 24 h was not an independent risk factor for mechanical complications, catheter migration, or infectious complications (p > 0.05). A BI ≤ 24 h was not an independent significant risk factor for technique failure by multivariate Cox regression analysis (p > 0.05). The subgroup analysis of patients who did not receive temporary HD returned the same results.Conclusion Initiating PD within 24 h of catheter insertion was not associated with increased mechanical complications, infectious complications, or technique failures.