Does peritoneal dialysis have a role in urgent‐start end‐stage kidney disease?. Issue 4 (19th April 2018) - McQuillan, Rory F.
Abstract: Despite its many positive attributes, peritoneal dialysis remains underutilized, particularly in the United States. Urgent‐start peritoneal dialysis (PD) has been proposed as a method of increasing PD prevalence. Urgent‐start PD has been shown to be safe, feasible, and effective. However, urgent‐start PD is also accompanied by several multidimensional challenges. This article is intended to equip the reader with a practical sense of whether an urgent‐start PD program would be appropriate in his or her own clinical context and if appropriate, what factors would be necessary for such a program to flourish. As such, we summarize latent factors, which are necessary to consider before instituting an urgent‐start PD. Then, using a series of clinical vignettes, highlight the component parts of a successful urgent‐start PD program and the patient population who stand to benefit most from this strategy. The discussion is then balanced by presenting limitations to consider in the urgent‐start PD approach.