title: Infrastructure requirements for an urgent-start peritoneal dialysis program.
abstract: Patients with advanced chronic kidney disease nearing dialysis but without pre-established access almost uniformly initiate dialysis with a temporary central venous catheter. These catheters are associated with high rates of infection and flow disturbances, requiring removal and subsequent replacement. Many of these patients might be candidates for peritoneal dialysis (PD), but because of the absence of prior catheter placement, the default initial modality is hemodialysis. Recent reports, however, have demonstrated the feasibility of initiating PD urgently despite the late referral for access placement. Urgent-start PD clinical pathways require a unique infrastructure and treatment approach. This article reviews the salient features required to establish an urgent-start PD program.
authors: Division of Nephrology,1 Keck School of Medicine, University of Southern California, Los Angeles, California;
authors: Arshia
authors: A
authors: Ghaffari
authors: Vijay
authors: V
authors: Kumar
authors: Steven
authors: S
authors: Guest
mesh_terms: D000553:Ambulatory Care; D002408:Catheters, Indwelling; D002985:Clinical Protocols / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000628:therapy; D010530:Peritoneal Dialysis / Q000379:methods / Q000592:standards; D016730:Program Development; D015641:Radiography, Interventional; D013997:Time Factors; D062666:Vascular Access Devices
keywords: Urgent initiation; infrastructure; interventional radiology; outcomes; prescription; vascular access