Urgent-start Peritoneal Dialysis in ESRD Patients：A Multi-center Study
Condition: End-Stage Renal Disease
MeSH terms: Kidney Failure, Chronic
Study type: Interventional

Summary: 
      Within the last decade, urgent-start peritoneal dialysis(PD) has gained considerable interest
      amongst nephrologists. Several publications have provided assurances that urgent-start PD is
      indeed feasible and can serve patients well; however, most of the studies have small sample
      sizes, retrospective design, and the impact of the urgent-start dialysis modality on outcome,
      especially on short-term complications, has not been directly evaluated. Therefore, we
      started this multi-centered, prospective, interventional study compared the dialysis-related
      complications and survival rate directly between urgent-start PD and HD groups with a large
      sample to determine the feasibility and safety of urgent-start PD as an alternate initial
      modality of dialysis for patients who require urgent initiation of dialysis therapy.
    

Detailed description: 
      The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is on the
      rise worldwide. Moreover, many patients who progress to ESRD, even with regular nephrology
      follow-up, do not have a distinct plan at the time of initiating dialysis therapy, resulting
      in an urgent need for dialysis. Urgent-start dialysis refers to urgent initiation of dialysis
      for ESRD patients with no pre-established functional vascular access or peritoneal dialysis
      (PD) catheter. Hemodialysis (HD) is preferred in most centers with a high rate of central
      venous catheter (CVC) use at the time of initiating dialysis among HD patients. There is a
      significantly increased risk of infectious complications, thrombosis, and other complications
      associated with CVC use which negatively affects patient prognosis. Within the last decade,
      urgent-start PD has gained considerable interest amongst nephrologists. Several publications
      have provided assurances that urgent-start PD is indeed feasible and can serve patients well;
      however, most of the studies have small sample sizes, and the impact of the urgent-start
      dialysis modality on outcome, especially on short-term complications, has not been directly
      evaluated. Therefore, we conducted this multicenter, prospective, randomized clinical trial
      to compare the dialysis-related complications and survival rate directly between urgent-start
      PD and HD groups with a large sample to determine the feasibility and safety of urgent-start
      PD as an alternate initial modality of dialysis for patients who require urgent initiation of
      dialysis therapy.
    

Intervention name(s): urgent-start peritoneal dialysis catheter; central venous catheter
Intervention type(s): Device; Device
Intervention description(s): Patients initiated peritoneal dialysis as urgent-start dialysis modality with a peritoneal dialysis catheter.; Patients initiated hemodialysis as urgent-start dialysis modality with a central venous catheter.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment