An integrated review of "unplanned" dialysis initiation: reframing the terminology to "suboptimal" initiation

An integrated review of "unplanned" dialysis initiation: reframing the terminology to "suboptimal" initiation

BACKGROUND Ideally, care prior to the initiation of dialysis should increase the likelihood that patients start electively outside of the hospital setting with a mature arteriovenous fistula (AVF) or peritoneal dialysis (PD) catheter. However, unplanned dialysis continues to occur in patients both known and unknown to nephrology services, and in both late and early referrals. The objective of t...

A review of unplanned dialysis initiation: an opportunity to improve clinical and socioeconomic outcomes

Can peritoneal dialysis be applied for unplanned initiation of chronic dialysis?

Late referral of patients with chronic kidney disease (CKD) and unforeseeable deterioration of residual renal function in known CKD patients remain a major problem leading to the need of unplanned start on chronic dialysis without a mature access for dialysis. In most centres worldwide, these patients are started on haemodialysis (HD) using a temporary tunnelled central venous catheter (CVC) fo...

Is rapid initiation of peritoneal dialysis feasible in unplanned dialysis patients? A single-centre experience.

BACKGROUND Starting dialysis in an unplanned manner is a frequent situation in a dialysis centre even for patients with a regular nephrology follow-up. For no clear reason, chronic haemodialysis (HD) is more frequently used than peritoneal dialysis for unplanned dialysis patients. OBJECTIVE The purpose of this study was to evaluate the results of a dialysis policy dedicated to unplanned dialy...

Suboptimal initiation of dialysis with and without early referral to a nephrologist.

BACKGROUND Our objective was to examine patients who initiate renal replacement therapy (RRT) at 10 representative Canadian centers, characterize their initiation as inpatient or outpatient and describe their initial type of dialysis access, duration of pre-dialysis care and clinical status at the time of dialysis initiation. We also examined the impact of an optimal dialysis start (i.e. initia...