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Age at diagnosis and cancer subtype may affect risk for CV death among cancer survivors

According to studies published in Kidney Medicine, patients who started urgent start peritoneal diagnosis in an integrated health care system had good survival and modality retention rates one year later.

Furthermore, experts propose that in circumstances requiring an unanticipated dialysis start, urgent start PD should be explored.

Sijie Zheng, MD, PhD, of Kaiser Permanente Medical Center in Oakland, California, and colleagues noted, “Urgent start PD has been demonstrated to have a low incidence of complications such as peritonitis, leaks, catheter malfunction, hospitalizations, and modality failure, with excellent 90-day outcomes.” “The goal of this study was to look at the demographic and clinical characteristics of patients who were started on urgent PD and to assess complications, survival rates, and modality failure at predetermined time intervals.”

Researchers followed 84 adult Kaiser Permanente Northern California members who started to start PD between January 1, 2011 and December 12, 2014 in a retrospective cohort analysis. Binomial proportions were used to calculate patient retention rates at 30, 90, and 365 days. Researchers calculated the cumulative incidence of all-cause death using the Kaplan-Meier method.

Major problems occurred in less than 5% of the sample, while catheter dysfunction occurred in 6%. Peritoneal peritonitis and exit site infections affected 20% of the patients. Furthermore, one year after starting PD, total all-cause mortality was 9.7%. At 30 days, 90 days, and 365 days, retention rates were found to be 98.8%, 91.3 percent, and 80%, respectively.

“Urgent start PD has been proved to be a safe, viable, and sustainable treatment option within an integrated health care system.” According to Zheng and colleagues, “urgent start PD should be more frequently employed for patients who require prompt and unscheduled diagnosis starting, given the recent executive directive for boosting home dialysis incidence.” “It’s unclear if our findings apply to other health-care systems where service delivery has traditionally been more decentralised.” To corroborate the findings, a prospective, multicenter randomised trial should be conducted.”

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