机构：[1]Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[2]MolecularCell Laboratory for Kidney Disease, Shanghai, China[3]Shanghai Peritoneal Dialysis Research Center, Shanghai, China[4]UremiaDiagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China[5]Department ofNephrology, Shanghai Songjiang District Central Hospital, Shanghai, China[6]Department of Nephrology, Longhua Hospital,Shanghai University of Traditional Chinese Medicine, Shanghai, China[7]Department of Nephrology, Affiliated Hospital ofJiangxi University of Traditional Chinese Medicine, Nanchang China[8]Department of Nephrology, Central Hospital of ShanghaiJiading District, Shanghai, China[9]Department of Nephrology, Ruijin Hospital Affiliated to Shanghai Jiao Tong UniversitySchool of Medicine, Shanghai, China[10]Department of Nephrology, Sixth People’s Hospital Affiliated to Shanghai Jiao TongUniversity School of Medicine, Shanghai, China[11]Department of Nephrology, Xinhua Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, Shanghai, China[12]Department of Nephrology, Changhai Hospital, Naval Medical University, Shanghai,China[13]Department of Nephrology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[14]Department of Nephrology, Shanghai Punan Hospital, Shanghai, China
Introduction: Peritoneal dialysis (PD) shows promise for urgent-start dialysis in end-stage renal disease (ESRD), with automated PD (APD) having advantages. However, there is limited multicenter randomized controlled trial (RCT) evidence comparing APD with temporary hemodialysis (HD) for this indication in China. Methods: This multicenter RCT enrolled 116 patients with ESRD requiring urgent dialysis from 11 hospitals, randomized to APD or HD. Patients underwent a 2-week treatment with APD or HD via a temporary central venous catheter (CVC), followed by a maintenance PD. Outcomes were assessed over 12 months during 8 visits. The primary outcome was dialysis-related complications. Results: The 1-year incidence of dialysis-related complications was significantly lower in the APD group than in the HD group (25.9% vs. 56.9%, P = 0.001). No significant differences were found between the groups in terms of PD catheter survival rates (P P = 0.388), peritonitis-free survival rates (P P = 0.335), and patient survival rates (P P = 0.329). In terms of health economics, the total direct medical cost of the initial hospitalization for patients with ESRD was significantly lower in the APD group (27,008.39 CNY) than in the HD group (42,597.54 CNY) (P P = 0.001), whereas the duration of the first hospital stay showed no significant difference (P P = 0.424). Conclusion: For patients with ESRD needing urgent initiation of dialysis, APD was associated with a lower incidence of dialysis-related complications and lower initial hospitalization costs compared with HD, with no significant differences in PD catheter survival rate, peritonitis-free survival rates, or patient survival rates. These findings can guide clinical decision-making for the optimal dialysis modality for patients requiring urgent dialysis initiation.
基金：
Clinical Research Plan of SHDC [DLY201805]; Sailing Program of Shanghai Municipal Science and Technology Commission [SHDC2020CR3029B]; [21YF1425400]
第一作者机构：[1]Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[2]MolecularCell Laboratory for Kidney Disease, Shanghai, China[3]Shanghai Peritoneal Dialysis Research Center, Shanghai, China[4]UremiaDiagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China[2]MolecularCell Laboratory for Kidney Disease, Shanghai, China[3]Shanghai Peritoneal Dialysis Research Center, Shanghai, China[4]UremiaDiagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China[*1]Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160, Pujian Road, Shanghai 200127, China
推荐引用方式(GB/T 7714)：
Haijiao Jin,Wei Fang,Ling Wang,et al.A Randomized Controlled Trial Comparing Automated Peritoneal Dialysis and Hemodialysis for Urgent-Start Dialysis in ESRD[J].KIDNEY INTERNATIONAL REPORTS.2024,9(9):2627-2634.doi:10.1016/j.ekir.2024.06.032.
APA：
Haijiao Jin,Wei Fang,Ling Wang,Xiujuan Zang,Yueyi Deng...&Zhaohui Ni.(2024).A Randomized Controlled Trial Comparing Automated Peritoneal Dialysis and Hemodialysis for Urgent-Start Dialysis in ESRD.KIDNEY INTERNATIONAL REPORTS,9,(9)
MLA：
Haijiao Jin,et al."A Randomized Controlled Trial Comparing Automated Peritoneal Dialysis and Hemodialysis for Urgent-Start Dialysis in ESRD".KIDNEY INTERNATIONAL REPORTS 9..9(2024):2627-2634
