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Title: The modality of choice, manual or automated, for urgent start peritoneal dialysis
Authors: Javaid, M.M.
Khan, B.A. 
Subramanian, S. 
Keywords: Automated peritoneal dialysis
Continuous ambulatory peritoneal dialysis
End-stage renal disease
Urgent start
Issue Date: 2019
Publisher: Oxford University Press
Citation: Javaid, M.M., Khan, B.A., Subramanian, S. (2019). The modality of choice, manual or automated, for urgent start peritoneal dialysis. Clinical Kidney Journal 12 (3) : 443-446. ScholarBank@NUS Repository.
Rights: Attribution-NonCommercial 4.0 International
Abstract: Over the last decade, urgent start peritoneal dialysis (USPD), defined as initiation of peritoneal dialysis (PD) before the traditionally recommended break-in period of 2-4 weeks, has increasingly been seen as a viable option for late-presenting end-stage renal disease patients, obviating the need for haemodialysis via central venous catheter. Different prescriptions and protocols involving both manual and automated exchanges have been published, but there is no head-to-head comparison of the two modalities and no consensus on the most suitable modality exists. Evaluation of the available evidence suggests that PD can be initiated urgently using either or both options without much difference in the outcome. The two most critical aspects dictating the success of a USPD programme are using low dwell volumes and keeping patients in a strict supine position during the dialysis exchanges in the first couple of weeks of the therapy. These measures are crucial in keeping the intraperitoneal pressure to a minimum and reduce the risk of mechanical complications, including catheter leaks and malpositioning. © The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA.
Source Title: Clinical Kidney Journal
ISSN: 2048-8505
DOI: 10.1093/ckj/sfz008
Rights: Attribution-NonCommercial 4.0 International
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