Urgent-start Peritoneal Dialysis

Peritoneal Dialysis (PD) has several advantages over hemodialysis, including preservation of vasculature for future dialysis access, an initial survival advantage, cost effectiveness, and preservation of residual renal function. This chapter summarizes the evidence to date regarding the definition, prevalence, and outcomes of urgent-start PD. A barrier to broader uptake of urgent-start PD may be attributable to physician practice patterns, which may be largely contributed to by a lack of adequate resources necessary to execute urgent-start PD. Unlike conventional-start PD when initiation of therapy is delayed until at least 2 weeks after catheter insertion to promote wound healing, earlier treatment initiation has raised concerns about an increase in the risk of mechanical complications, such as per catheter leaks. There is a growing burden of patients with end-stage kidney disease worldwide, with increasing numbers of patients commencing on renal replacement therapy.