title: We Use Permcaths Instead of Peritoneal Catheters for Acute Kidney Injury and Urgent-Start Dialysis.
abstract: The rising tide of severe acute kidney injury requiring dialysis (AKI-D) and unplanned dialysis initiation for advanced CKD patients remains a major problem for the nephrology community worldwide. Hemodialysis (HD) through a central venous catheter remains the most common practice for both. Peritoneal dialysis (PD) remains greatly underutilized despite mounting evidence of equipoise with HD for a significant proportion of patients. PD is technically simpler, requires less infrastructure, and costs less. However, the structure of our healthcare system, hospital logistics, and the current state of nephrology training all contribute to the reflexive consult for a central venous catheter. As clinicians, we must ask ourselves if we are doing our patients and our healthcare system a disservice by not offering PD in AKI and urgent-start situations.
authors.affiliation: Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dean
authors.affiliation: Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California.
authors.forename: Dinna N
authors.initials: DN
authors.lastname: Cruz
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D002408:Catheters, Indwelling; D006801:Humans; D009398:Nephrology / Q000379:methods*; D010530:Peritoneal Dialysis; D006435:Renal Dialysis