Introduction
bacteremia, PD, MPD, ESRD
END-STAGE RENAL DISEASE, ESRD
Peritoneal dialysis (PD) is an effective treatment for patients with end-stage renal disease (ESRD). PD initiation is usually recommended at least two weeks after peritoneal dialysis catheter (PDC) implantation [Urgent-start peritoneal dialysis (USPD) is defined as the initiation of PD within two weeks of PDC implantation. Interestingly, our previous meta-analysis showed that all-cause mortality was comparable between patients undergoing USPD and urgent-start HD; however, the incidence of bacteremia was higher in patients receiving urgent-start HD [PD is usually performed using a manual fluid exchange peritoneal dialysis (MPD) or automated peritoneal dialysis (APD). APD has been proven to be a safe and effective alternative to urgent-start HD [Both adequate dialysis and skill training for fluid exchange are essential in USPD. However, APD alone or MPD alone could not meet the above demands. We hypothesize that a combination of APD with MPD (A-MPD) in USPD could have a better effect in removing small-molecule toxins and skill training. It may also allow the patients to receive multiple PD modes and choose the most suitable one for them. In this randomized controlled study, we compared A-MPD with MPD, aiming to investigate the efficacy and practicability of A-MPD and seek the most appropriate mode in ESRD patients undergoing USPD.