Urgent-Start Peritoneal Dialysis Has Similar Long-Term Technique Survival as Conventional-Start Peritoneal Dialysis

Background: Few studies have examined the long term technique survival of urgent-start peritoneal dialysis (USPD) as compared to conventional-start peritoneal dialysis (CSPD). There is concern patients performing USPD may have shorter technique survival compared to conventional start PD (CSPD). The aim of this study was to compare the length of time on therapy in patients starting PD via USPD versus CSPD. Methods: This is a single-center retrospective observational study comparing all incident patients that started PD between 1/1/2010 and 12/31/2024. USPD was defined as starting nurse-assisted PD in less than 14 days after peritoneal dialysis catheter placement. The length of time on therapy was determined from the date of PD start in the dialysis clinic until either death, transplant, transfer to another modality, transfer out of the clinic, or reaching the end of study (3/31/2025). Results: Our study included 175 USPD patients (mean age 46.3 years, 73.1% male) and 103 planned PD patients (mean age 51.3 years, 56.3% male). The average length of time on therapy for USPD patients vs CSPD was 1308 ± 1088 vs 1221 ± 1042 days [(p=0.26), 95% CI -173.8 to 341.8]. Comparison of causes of technique loss for the USPD compared to CSPD included: 1)Transfer to in-center hemodialysis, 18.2% versus 13.6% (p=0.58); 2) death, 14.3% versus 12.6% (p=0.40): 3) Kidney transplant, 8.5% versus 10.7% (p=0.91); and 4) Transfer out, 23.4% versus 27.2% (p=0.47). Conclusion: In this large long-term single-center study, time on therapy was not statistically different for USPD versus CSPD. Moreover, there was no difference in the reasons for coming off of PD. While further studies are needed, this study suggests that patients started on PD via the USPD pathway have similar long-term technique survival as compared to patients starting via CSPD.