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Date of Award

Spring 2024

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Kaitlyn Gamber, MHS, PA-C

Second Advisor

Alexia Arhontakis, MHS, PA-C

Abstract

Despite its chronic etiology, the silent manifestations of chronic kidney disease (CKD) cause many patients to present with symptoms requiring urgent, unplanned dialysis. Traditionally, these patients have been placed on hemodialysis (HD), which, when initiated urgently, carries a risk of lethal complications and is accompanied by a high cost. However, a viable alternative exists. Known as peritoneal dialysis, research suggests that this renal replacement therapy has the capability to provide patients with comparable clinical outcomes to HD at a lower cost while enhancing the patients’ quality of life. Regardless of its benefits, PD still trails behind HD when dialysis is implemented in urgent situations. This CME article will present the emerging evidence that supports PD as the first-line urgent renal replacement therapy (RRT) and can serve to guide clinicians’ decisions when faced with such scenarios.

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Urgent-Start Dialysis: Could PD Become First Line?

Despite its chronic etiology, the silent manifestations of chronic kidney disease (CKD) cause many patients to present with symptoms requiring urgent, unplanned dialysis. Traditionally, these patients have been placed on hemodialysis (HD), which, when initiated urgently, carries a risk of lethal complications and is accompanied by a high cost. However, a viable alternative exists. Known as peritoneal dialysis, research suggests that this renal replacement therapy has the capability to provide patients with comparable clinical outcomes to HD at a lower cost while enhancing the patients’ quality of life. Regardless of its benefits, PD still trails behind HD when dialysis is implemented in urgent situations. This CME article will present the emerging evidence that supports PD as the first-line urgent renal replacement therapy (RRT) and can serve to guide clinicians’ decisions when faced with such scenarios.