Table 5.

Culture change at UAB Medicine with the urgent start PD program

Nephrologists
 Improved access to PD, inpatient and outpatient
 Prompt PD catheter placement avoids need for temporary hemodialysis access
 Urgent PD protocols “make it easy”
 Smooth transition into dialysis unit prevent prolonged length of stay at the hospital
Interventional Radiology/Nephrology
 Enthusiastic support in catheter placement
 Innovative measures in patients with critical illness such as refractory heart failure
 Routine calls to PD team about patients with challenging vascular access to consider PD as an option
Trainees
 Choices of modality for unplanned dialysis starts, even in the hospital
 Urgent PD led to increasing interest in PD
 Multiple calls from trainees to consider patients for urgent start dialysis, either home hemodialysis or peritoneal dialysis
Access/Transplant Surgeons
 Tangible increase in surgeons suggesting home modalities to patients, even when evaluating for hemodialysis access
 Patients with failing renal allografts, especially sudden onset, referred for urgent home start
  • UAB, University of Alabama at Birmingham; PD, peritoneal dialysis.