Urgent unplanned peritoneal dialysis versus hemodialysis in end‐stage renal disease: Costs and outcomes

Abstract Objective To evaluate the efficacy and safety of urgent, unplanned peritoneal dialysis (PD) compared to hemodialysis (HD) in patients with end‐stage renal disease (ESRD). Methods This prospective cohort quasi‐experimental study enrolled 60 ESRD patients requiring urgent, unplanned dialysis. Participants were randomly assigned to automated peritoneal dialysis (APD) or daily dialysis (HD) at a tertiary hospital from May 2021 to June 2023. The primary outcome was patient survival. Secondary outcomes included infection rates, bacteremia, mechanical complications, catheter loss, cost, and hospitalization. All patients were followed for 3 months. Baseline characteristics were similar between groups. Results Of the 60 patients who started urgent unplanned dialysis, 5 (8.3%) died during the treatment and follow‐up period. There was no significant difference in the mortality rate between PD patients (6.7%) versus HD patients (10.0%). Overall infection rates were higher in the HD group (40.0%) compared to the PD group (6.7%) ( p = 0.014). HD patients had a significantly higher incidence of bacteremia in the follow‐up period compared to PD patients (20.0% versus 10.0%, p < 0.01). HD patients also had longer hospitalization stays (13.6 ± 4.1 days) compared to PD patients (6.2 ± 3.3 days, p 0.014). Additionally, the overall cost of dialysis was significantly higher for HD patients compared to PD patients ( p < 0.01). Conclusion Urgent, unplanned PD was as effective as HD in treating ESRD patients. PD was associated with lower infection rates, shorter hospital stays, and reduced costs, making it a safe, viable, and cost‐effective option for urgent dialysis.