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Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study

BACKGROUND: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients. OBJECTIVES: To compare the incidence and etiology of mechanical and infectious complications in patients offered planned- and urgent-start PD an...

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Autores principales: Müller, João Victor Costa, Ponce, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10139726/
https://www.ncbi.nlm.nih.gov/pubmed/35788617
http://dx.doi.org/10.1590/2175-8239-JBN-2021-0287en
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author Müller, João Victor Costa
Ponce, Daniela
author_facet Müller, João Victor Costa
Ponce, Daniela
author_sort Müller, João Victor Costa
collection PubMed
description BACKGROUND: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients. OBJECTIVES: To compare the incidence and etiology of mechanical and infectious complications in patients offered planned- and urgent-start PD and assess potential differences in patient survival and time on PD. METHODS: This retrospective cohort study included patients with chronic kidney disease on planned- and urgent-start PD seen from 2014 to 2020 and compared them for mechanical and infectious complications, clinical outcome, death rates, and need to switch to hemodialysis. RESULTS: Ninety-nine patients on planned-start PD and 206 on urgent-start PD were included. Incidence of exit-site infection (18.9 vs. 17.17%, p=0.71) and peritonitis (24.27 vs. 27.27%, p=0.57) were similar between patients, while pathogens causing peritonitis were different, although non-fermenting Gram-negative bacilli were more commonly seen in the planned-start PD group. Leakage as a mechanical complication and hospitalization were more common among patients needing urgent-start PD (10.68 vs. 2.02%, p=0.0085 and 35.44 vs. 17.17%, p=0.0011, respectively). Patient survival was similar between groups. Cox regression found an association between death and age (HR=1.051, 95% CI 1.026-1.07, p=0.0001) and albumin (HR=0.66, 95% CI 0.501-0.893, p=0.0064), and between peritonitis and a diagnosis of diabetes (HR=2.016, 95% CI 1.25-3.25, p=0.004). CONCLUSION: Patient survival and time on PD were similar between the planned- and urgent-start PD groups, while leakage was more frequently seen in the urgent-start PD group. Death was associated with lower albumin levels and older age, while peritonitis was associated with diabetes.
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spelling pubmed-101397262023-04-28 Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study Müller, João Victor Costa Ponce, Daniela J Bras Nefrol Original Article BACKGROUND: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients. OBJECTIVES: To compare the incidence and etiology of mechanical and infectious complications in patients offered planned- and urgent-start PD and assess potential differences in patient survival and time on PD. METHODS: This retrospective cohort study included patients with chronic kidney disease on planned- and urgent-start PD seen from 2014 to 2020 and compared them for mechanical and infectious complications, clinical outcome, death rates, and need to switch to hemodialysis. RESULTS: Ninety-nine patients on planned-start PD and 206 on urgent-start PD were included. Incidence of exit-site infection (18.9 vs. 17.17%, p=0.71) and peritonitis (24.27 vs. 27.27%, p=0.57) were similar between patients, while pathogens causing peritonitis were different, although non-fermenting Gram-negative bacilli were more commonly seen in the planned-start PD group. Leakage as a mechanical complication and hospitalization were more common among patients needing urgent-start PD (10.68 vs. 2.02%, p=0.0085 and 35.44 vs. 17.17%, p=0.0011, respectively). Patient survival was similar between groups. Cox regression found an association between death and age (HR=1.051, 95% CI 1.026-1.07, p=0.0001) and albumin (HR=0.66, 95% CI 0.501-0.893, p=0.0064), and between peritonitis and a diagnosis of diabetes (HR=2.016, 95% CI 1.25-3.25, p=0.004). CONCLUSION: Patient survival and time on PD were similar between the planned- and urgent-start PD groups, while leakage was more frequently seen in the urgent-start PD group. Death was associated with lower albumin levels and older age, while peritonitis was associated with diabetes. Sociedade Brasileira de Nefrologia 2022-07-04 2023 /pmc/articles/PMC10139726/ /pubmed/35788617 http://dx.doi.org/10.1590/2175-8239-JBN-2021-0287en Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons AttributionNoncommercial No Derivative License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.
spellingShingle Original Article
Müller, João Victor Costa
Ponce, Daniela
Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title_full Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title_fullStr Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title_full_unstemmed Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title_short Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
title_sort infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10139726/
https://www.ncbi.nlm.nih.gov/pubmed/35788617
http://dx.doi.org/10.1590/2175-8239-JBN-2021-0287en
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