Urgent-Start Peritoneal Dialysis in Metformin-Associated Lactic Acidosis: A Critical Alternative when Immediate Hemodialysis Is Unavailable.

Introduction: Intermittent hemodialysis (IHD) is a preferable renal replacement therapy (RRT) option in metformin-associated lactic acidosis (MALA) due to rapid correct metabolic acidosis. However, IHD might not be started immediately. Immediate urgent-start peritoneal dialysis (iUSPD) is used as a life-saving dialysis option and then followed by IHD.

Lower-Dosage Acute Peritoneal Dialysis versus Acute Intermittent Hemodialysis in Acute Kidney Injury: A Randomized Controlled Trial.

Key Points: The efficacy of acute peritoneal dialysis is still controversial. There was no significant difference in 28-day mortality between acute peritoneal dialysis and intermittent hemodialysis.

Background: Lower delivered dose of acute peritoneal dialysis (PD) in AKI requires less resources but raises concerns regarding adequate solute and water clearance.

The hidden financial catastrophe of chronic kidney disease under universal coverage and Thai "Peritoneal Dialysis First Policy".

Objective: Universal health coverage can decrease the magnitude of the individual patient's financial burden of chronic kidney disease (CKD), but the residual financial hardship from the patients' perspective has not been well-studied in low and middle-income countries (LMICs). This study aimed to evaluate the residual financial burden in patients with CKD stage 3 to dialysis in the "PD First Policy" under Universal Coverage Scheme (UCS) in Thailand.

Methods: This multicenter nationwide cross-sectional study in Thailand enrolled 1,224 patients with pre-dialysis CKD, hemodialysis (HD), and peritoneal dialysis (PD) covered by UCS and other health schemes for employees and civil servants.

Metformin-associated lactic acidosis and factors associated with 30-day mortality.

Background: Metformin-associated lactic acidosis (MALA) is a rare event but underrecognition may lead to unfavorable outcomes in type 2 diabetes patients. While many risk factors of MALA have been identified, how to reduce mortality from MALA is a matter of debate. This study aimed to explore the factors associated with 30-day mortality amongst MALA patients.

Randomized Study of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Temporary Hemodialysis in Patients Transitioning to Kidney Failure.

Introduction: We sought to evaluate the efficacy and complications of urgent-start peritoneal dialysis (PD) compared with urgent-start temporary hemodialysis (HD) followed by subsequent elective transfer to PD.

Methods: In this multicenter open-label prospective randomized controlled trial, adults with kidney failure who required immediate dialysis but did not have access to definitive dialysis were randomized to receive either urgent-start PD or urgent-start temporary HD over 2 weeks to 4 weeks followed by a transition to a chronic PD program according to the country policy. The primary outcome was the composite end point of operation-related, catheter-related, and dialysis-related complications at 6 weeks.

Outcomes after Acute Peritoneal Dialysis for Critical Cardiorenal Syndrome Type 1.

Introduction: The aim of the study was to demonstrate the outcomes of peritoneal dialysis (PD) in critically ill cardiorenal syndrome type 1 (CRS1).

Methods: A cohort of 147 patients with CRS1 who received PD from 2011 to 2019 in a referral hospital in Thailand was analyzed. The primary outcome was 30-day in-hospital mortality.

ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 update (adults).

Summary Statements: (1) Peritoneal dialysis (PD) should be considered a suitable modality for treatment of acute kidney injury (AKI) in all settings .

Guideline 2: Access And Fluid Delivery For Acute Pd In Adults: (2.1) Flexible peritoneal catheters should be used where resources and expertise exist .

Peritoneal dialysis with a lower dosage versus conventional intermittent hemodialysis in acute kidney injury: A propensity-matched study.

Background: Literature regarding the outcomes of lower dosage peritoneal dialysis (PD) in treating acute kidney injury (AKI) among resource-limited setting is sparse. This study aims to compare the risk of mortality in patients with AKI receiving lower PD dosage and conventional intermittent hemodialysis (IHD) in Thailand.

Methods: In a tertiary center in Thailand, a matched case-control study using propensity scores in patients with AKI was conducted to compare the outcomes between lower PD dosage (18 L per day for first two sessions, weekly / 2.

Customized versus conventional video counseling for peritoneal dialysis decision-making in patients with stage 5 chronic kidney disease under a PD-first policy: a randomized controlled study.

Background: Indecision regarding the start of peritoneal dialysis (PD) is a challenging problem in chronic kidney disease (CKD) stage 5 patients who receive conventional video counseling. This study aimed to evaluate the effect of video counseling customized to the local context versus conventional video counseling on PD decision-making in CKD stage 5 patients under PD-first policy.

Methods: We enrolled 120 patients with stage 5 CKD in Thailand who initiate PD between May 2016 to January 2017 in a randomized, open-label, controlled study.

Intensive Versus Minimal Standard Dosage for Peritoneal Dialysis in Acute Kidney Injury: A Randomized Pilot Study.

Background: Dosage for peritoneal dialysis (PD) in acute kidney injury (AKI) is controversial. This study aims to find benefits and risks of intensive versus minimal standard dosage of PD in AKI.

Methods: In a tertiary-hospital, 93 AKI patients who required PD between May 2015 and January 2016 were enrolled in a randomized, open-label controlled study.