Short- and long-term outcomes of early initiation of peritoneal dialysis following catheter insertion

Introduction: Early-start peri-toneal dialysis (PD) (use of PD catheter within 48 hours of insertion) is an innova-tive approach for prompt initiation of PD. Aim: This study was conducted to analyze the outcomes of early-start PD. Materials and methods: A total of 100 patients on PD were retrospectively analyzed. Patients were grouped according to the ???break-in period???: < 48 hours (PD1) and ??? 14 days (PD2). PD was initiated with low dwell vol-umes (500 mL) in a recumbent position within 48 hours of surgery. PD prescription was gradually incremented over 10 days to minimize any complications. Results: In our study, there were 48 patients in the PD1 group and 52 in the PD2 group. The most common cause of end-stage kidney disease (ESKD) was diabetes mellitus in both groups. Incidence of early mechanical complica-tions (within 30 days of catheter insertion), such as catheter obstruction, early catheter leakage, catheter malposition, tip migra-tion, and infectious complications, were not found to be higher in the PD1 group. 1-and 4-year catheter patency rates were 97.0% and 96.2% in the PD1 group, respectively. These rates were comparable with those in the PD2 group. Early-start PD was not asso-ciated with an increased incidence of cath-eter failure (HR = 1.0, 95% CI 0.28 ??? 3.47). Conclusion: An early break-in period of < 48 hours is a feasible option for ESKD patients without any significantly increased risk of mechanical or infectious complications. It offers a safe and efficacious option for renal replacement therapy.