title: Urgent-Start Peritoneal Dialysis Complications: Prevalence and Risk Factors.
abstract: BACKGROUND
  Mechanical complications are of particular concern in urgent-start peritoneal dialysis (PD) because of the shorter break-in period. However, risk factors have been reported inconsistently and data in urgent-start PD populations are limited.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  All patients treated with urgent-start PD, defined as PD therapy initiated within 1 week after catheter insertion, January 2003 to May 2013.
  
  
  METHODS
  Age, sex, abdominal surgery history, body mass index, hemoglobin level, albumin level, C-reactive protein level, break-in period (period between catheter insertion and PD therapy initiation), dialysate exchange volume, and use of overnight dwell.
  
  
  RESULTS
  The presence of mechanical complications related to abdominal wall or catheter, including hernia, hydrothorax, hydrocele, subcutaneous leak, pericatheter leak, catheter malposition, omental wrap, and obstruction.
  
  
  RESULTS
  922 patients on urgent-start PD therapy were enrolled (mean age, 59.1±15.0 [SD] years). Prevalences of abdominal wall and catheter complications were 4.8% and 9.5%, respectively. The most common abdominal wall complication was hernia (55%), followed by hydrothorax (25%). On adjustment, male sex (HR, 5.41; 95% CI, 2.15-13.59; P<0.001) and history of abdominal surgery (HR, 2.34; 95% CI, 1.04-5.26; P=0.04) were independently associated with higher risk for developing abdominal wall complications.
  
  
  CONCLUSIONS
  As a cohort study, comparisons could not be established between urgent-start PD and conventional PD.
  
  
  CONCLUSIONS
  Urgent-start PD is a safe and practicable approach. Male sex and history of abdominal surgery could contribute to the development of abdominal wall complications.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University; and Key Laboratory of Renal Disease, National Health and Family Planning Commission of the People's Republic of China, Beijing, PR China.
authors.forename: Damin
authors.initials: D
authors.lastname: Xu
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University; and Key Laboratory of Renal Disease, National Health and Family Planning Commission of the People's Republic of China, Beijing, PR China.
authors.forename: Tianjiao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University; and Key Laboratory of Renal Disease, National Health and Family Planning Commission of the People's Republic of China, Beijing, PR China. Electronic address: jie.dong@bjmu.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
mesh_terms: D000465:Algorithms; D000553:Ambulatory Care; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors
keywords: Peritoneal dialysis (PD); abdominal wall complications; break-in period; catheter complications; catheter obstruction; emergent dialysis; end-stage renal disease (ESRD); hernia; hydrothorax; risk factor; technique failure; technique survival; urgent-start PD