Is It Safe to Initiate Peritoneal Dialysis Treatment Immediately After Percutaneous Catheter Placement?

Abstract

In this retrospective study, the safety of initiating peritoneal dialysis (PD) immediately after percutaneous PD catheter insertion was evaluated. Patients who underwent peritoneal catheter insertion and then immediately began dialysis treatment were included in the study. Patient age, sex, treatment modalities, and method of catheter insertion were recorded.Acute PD was performed in 33 patients (age: 57.7 ± 16.7 years; 21 men, 12 women). Catheters were inserted percutaneously in 28 patients and surgically in 5 patients. The PD modalities used were continuous ambulatory PD in 18 patients, automated PD in 11 patients, and both modalities in 4 patients. Acute PD was started within 24 hours of catheter insertion. Leaks occurred in 8 patients who had catheters inserted percutaneously (28.5%). Peritonitis occurred in 1 patient. No complications were observed in 24 patients. Leaks were fully resolved for patients kept in a supine position, with fill volumes reduced to 500 mL - 700 mL and the dwell period decreased to 60 minutes from 120 minutes. Leaks were not observed in the patients when the fill volume was increased by 200 mL and the dwell period was increased by 30 minutes every 2 days to reach 1300 mL and 180 minutes by the 7th day.Immediate-start dialysis after percutaneous peritoneal catheter insertion seems safe when performed in a supine position with low-volume exchanges and short dwell times.