Đánh giá bước đầu phương pháp lọc màng bụng sớm dành cho bệnh nhân suy thận mạn giai đoạn cuối tại Bệnh viện Đại học Y dược thành phố Hồ Chí Minh

To investigate urgent-start peritoneal dialysis (PD) for unplanned dialysis end-stage renal disease (ESRD) patients at the University Medical Center, Ho Chi Minh City. Method: We conducted a prospective observational cohort study from November 2020 to May 2023 to examine the use of urgent-start PD for unplanned ESRD patients. Urgent-start PD was defined as the initiation of PD therapy within 14 days after catheter insertion. We recorded data on dialysis prescription, dialysis-related complications and short-term (3 months) outcomes for patients who met the inclusion criteria and did not have any exclusion criteria. Results: Our study enrolled 68 patients with a mean age of 59.63±12.9 years, with a female-to-male ratio of 3:2). The median break-in period (the time between catheter insertion and the start of PD therapy) was 4 days (interquartile range 4 – 5 days). The patients were treated with automated peritoneal dialysis (APD) in a supine position on the first day, with a dialysis prescription set at a low fill volume of 600 mL, dwell time of 6 hours, and a total exchange volume of 5 L/day. The prevalence of dialysis-related complications was 19.1% with infection related complications at 10.3% and mechanical complications at 14.7% during the first month. In the first three months, eight cases required catheter repositioning with surgery (five cases due to a fallopian tube inserted into the catheter and three cases due to omental wrap). We observed positive short-term (3 months) outcomes with 100% of patients continuing with PD and experiencing improvements in biochemistry results including serum urea, hemoglobin, albumin levels. Conclusion: Our findings suggest that urgent-start PD is a safe, effective and practical approach for the treatment of unplanned dialysis ESRD patients.