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Setting up Successful Urgent-start Peritoneal Dialysis Programs

Peritoneal dialysis (PD) is greatly under-utilized in most parts of the world, despite being preferred by many nephrologists and patients. Various factors, including late end-stage referrals and urgent kidney replacement therapy, mean that PD may not be considered as a treatment option. But new techniques for urgent-start peritoneal dialysis (USPD) allow for treatment initiation within days.

Dr. Esther Tan Zhao Zhi is a consultant nephrologist at the Selayang Hospital near Kuala Lumpur in Malaysia. In her talk at WCN’22, she will discuss how USPD programs work and the key elements for their success.

Dr. Tan Zhao Zhi comments: “Planning for patients’ long-term kidney replacement therapy is important, especially in a country such as Malaysia where rates of kidney transplantation are low, and patients remain on dialysis for most of their life. Unplanned dialysis often exposes patients to a risk of infection and catheter-related complications and has a high mortality rate. Using USPD could be a good alternative for some patients.”

With acute kidney injury (AKI) being one of the complications of CO­VID-19, there has been an unanticipated surge in the number of patients with AKI over the last two years. Dr. Tan Zhao Zhi adds, “An increased number of patients, combined with a limited pool of trained staff and reduced access to continuous kidney replacement therapy and hemodialysis machines, mean our clinicians have had to adapt rapidly and solve problems creatively. Faced with these challenges, USPD has a big role to play in planning the future of patient care.”

Peritoneal dialysis is a growing field, and many more centers in Malaysia now offer USPD. “I hope that peritoneal dialysis will become the preferred modality of kidney replacement therapy compared to hemodialysis in suitable candidates, as well as those waiting for a kidney transplant,” she adds.

Esther Tan Zhao Zhi: “PD first”, Special Session “The Future is Bright: Young Nephrologists in Action”, Friday 25 February, 18:00-19:30 hrs Kuala Lumpur (Malaysia) time:!sessiondetails/0000015720_0

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