Abstract Background: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients. Objectives: To compare the incidence and etiology of mechanical and infectious complications in patients offered planned- and urgent-start PD and assess potential differences in patient survival and time on PD. Methods: This retrospective cohort study included patients with chronic kidney disease on planned- and urgent-start PD seen from 2014 to 2020 and compared them for mechanical and infectious complications, clinical outcome, death rates, and need to switch to hemodialysis. Results: Ninety-nine patients on planned-start PD and 206 on urgent-start PD were included. Incidence of exit-site infection (18.9 vs. 17.17%, p=0.71) and peritonitis (24.27 vs. 27.27%, p=0.57) were similar between patients, while pathogens causing peritonitis were different, although non-fermenting Gram-negative bacilli were more commonly seen in the planned-start PD group. Leakage as a mechanical complication and hospitalization were more common among patients needing urgent-start PD (10.68 vs. 2.02%, p=0.0085 and 35.44 vs. 17.17%, p=0.0011, respectively). Patient survival was similar between groups. Cox regression found an association between death and age (HR=1.051, 95% CI 1.026-1.07, p=0.0001) and albumin (HR=0.66, 95% CI 0.501-0.893, p=0.0064), and between peritonitis and a diagnosis of diabetes (HR=2.016, 95% CI 1.25-3.25, p=0.004). Conclusion: Patient survival and time on PD were similar between the planned- and urgent-start PD groups, while leakage was more frequently seen in the urgent-start PD group. Death was associated with lower albumin levels and older age, while peritonitis was associated with diabetes. Background plannedstart planned start urgentstart urgent (PD Objectives Methods 201 202 outcome rates hemodialysis Results Ninetynine Ninety nine 20 exitsite exit site 18.9 189 18 9 (18. vs 1717 17 17.17% p=0.71 p071 p 0 71 24.27 2427 24 27 (24.2 2727 27.27% p=0.57 p057 57 different nonfermenting non fermenting Gramnegative Gram negative group 10.68 1068 10 68 (10.6 2 02 2.02% p00085 0085 p=0.008 3544 35 44 35.4 p00011 0011 p=0.0011 respectively. respectively . respectively) groups HR=1.051, HR1051 HR 1 051 (HR=1.051 95 1.0261.07, 1026107 1.026 1.07, 026 07 1.026-1.07 p=0.0001 p00001 0001 HR=0.66, HR066 66 (HR=0.66 0.5010.893, 05010893 0.501 0.893, 501 893 0.501-0.893 p=0.0064, p00064 p=0.0064 , 0064 p=0.0064) HR=2.016, HR2016 016 (HR=2.016 1.253.25, 125325 1.25 3.25, 25 3 1.25-3.25 p=0.004. p0004 p=0.004 004 p=0.004) Conclusion 18. (18 171 17.17 p=0.7 p07 7 24.2 242 (24. 272 27.27 p=0.5 p05 5 10.6 106 6 (10. 2.02 p0008 008 p=0.00 354 4 35. p0001 001 p=0.001 HR=1.051 HR105 05 (HR=1.05 0261 1.0261.07 102610 1026 1.02 107 1.07 1.026-1.0 p=0.000 p0000 000 HR=0.66 HR06 (HR=0.6 5010 0.5010.893 0501089 0501 0.50 0893 0.893 50 89 0.501-0.89 p0006 p=0.006 006 HR=2.016 HR201 01 (HR=2.01 253 1.253.25 12532 125 1.2 325 3.25 1.25-3.2 p000 00 (1 17.1 p=0. p0 24. (24 27.2 10. (10 2.0 p=0.0 HR=1.05 HR10 (HR=1.0 1.0261.0 10261 102 1.0 1.026-1. HR=0.6 HR0 (HR=0. 0.5010.89 050108 050 0.5 089 0.89 8 0.501-0.8 HR=2.01 HR20 (HR=2.0 1.253.2 1253 12 1. 32 3.2 1.25-3. p00 ( 17. p=0 (2 27. 2. HR=1.0 HR1 (HR=1. 1.0261. 1.026-1 HR=0. (HR=0 0.5010.8 05010 0. 08 0.8 0.501-0. HR=2.0 HR2 (HR=2. 1.253. 3. 1.25-3 p= HR=1. (HR=1 1.0261 1.026- HR=0 (HR= 0.5010. 0.501-0 HR=2. (HR=2 1.253 1.25- HR=1 HR= (HR 0.5010 0.501- HR=2

Resumo Antecedentes: Poucos estudos compararam as complicações infecciosas e mecânicas relacionadas à diálise peritoneal (DP) de início planejado e não planejado. Objetivos: Comparar a incidência e etiologia das complicações mecânicas e infecciosas associadas à DP tanto de início planejado quanto não planejado e avaliar comparativamente a sobrevida da técnica e dos pacientes. Métodos: Estudo de coorte retrospectivo que avaliou pacientes com doença renal crônica em DP não planejada e planejada de 2014 a 2020 quanto às complicações mecânicas e infecciosas e desfechos clínicos óbito ou mudança para hemodiálise. Resultados: Foram avaliados 99 pacientes em DP planejada e 206 em DP não planejada. Foram semelhantes quanto à incidência de Infecção do Orifício de Saída (18,9x17,17%, p=0,71), peritonite (24,27x27,27%, p=0,57) e diferentes quanto aos agentes etiológicos das peritonites, sendo os bacilos Gram-negativos não fermentadores mais frequentes no grupo planejado. Diferiram quanto à complicação mecânica extravasamento e internação, ambas mais frequentes no grupo não planejado (10,68 x 2,02%, p=0,0085 e 35,44 x 17,17%, p=0,0011, respectivamente). Semelhantes quanto à sobrevida dos pacientes e da técnica. À regressão de Cox, associou ao óbito a idade (HR=1,051, IC 95% 1,026-1,07, p=0,0001) e a albumina (HR=0,66, IC 95% 0,501-0,893, p=0,0064), e à peritonite a presença de diabetes (HR=2,016, IC 95% 1,25-3,25, p=0,004). Conclusão: A sobrevida da técnica e dos pacientes foi semelhante nos grupos DP planejada e não planejada, enquanto o extravasamento foi mais frequente no grupo de início não planejado. Associaram-se ao óbito menores valores de albumina e maior idade, e à peritonite, o diabetes. Antecedentes (DP Objetivos Métodos 201 202 hemodiálise Resultados 9 20 18,9x17,17%, 189x1717 18 9x17 17 (18,9x17,17% p=0,71, p071 p p=0,71 , 0 71 p=0,71) 24,27x27,27%, 2427x2727 24 27x27 27 (24,27x27,27% p=0,57 p057 57 peritonites Gramnegativos Gram negativos internação 10,68 1068 10 68 (10,6 2 02 2,02% p00085 0085 p=0,008 3544 35 44 35,4 1717 17,17% p00011 0011 p=0,0011 respectivamente. respectivamente . respectivamente) Cox HR=1,051, HR1051 HR 1 051 (HR=1,051 95 1,0261,07, 1026107 1,026 1,07, 026 07 1,026-1,07 p=0,0001 p00001 0001 HR=0,66, HR066 66 (HR=0,66 0,5010,893, 05010893 0,501 0,893, 501 893 0,501-0,893 p=0,0064, p00064 p=0,0064 0064 p=0,0064) HR=2,016, HR2016 016 (HR=2,016 1,253,25, 125325 1,25 3,25, 25 3 1,25-3,25 p=0,004. p0004 p=0,004 004 p=0,004) Conclusão Associaramse Associaram se 18,9x17,17% 189x171 9x1 (18,9x17,17 p07 p=0,7 7 24,27x27,27% 2427x272 27x2 (24,27x27,27 p=0,5 p05 5 10,6 106 6 (10, 2,02 p0008 008 p=0,00 354 4 35, 171 17,17 p0001 001 p=0,001 HR=1,051 HR105 05 (HR=1,05 0261 1,0261,07 102610 1026 1,02 107 1,07 1,026-1,0 p=0,000 p0000 000 HR=0,66 HR06 (HR=0,6 5010 0,5010,893 0501089 0501 0,50 0893 0,893 50 89 0,501-0,89 p0006 p=0,006 006 HR=2,016 HR201 01 (HR=2,01 253 1,253,25 12532 125 1,2 325 3,25 1,25-3,2 p000 00 18,9x17,17 189x17 9x (18,9x17,1 p0 p=0, 24,27x27,27 2427x27 27x (24,27x27,2 10, (10 2,0 p=0,0 17,1 HR=1,05 HR10 (HR=1,0 1,0261,0 10261 102 1,0 1,026-1, HR=0,6 HR0 (HR=0, 0,5010,89 050108 050 0,5 089 0,89 8 0,501-0,8 HR=2,01 HR20 (HR=2,0 1,253,2 1253 12 1, 32 3,2 1,25-3, p00 18,9x17,1 189x1 (18,9x17, p=0 24,27x27,2 2427x2 (24,27x27, (1 2, 17, HR=1,0 HR1 (HR=1, 1,0261, 1,026-1 HR=0, (HR=0 0,5010,8 05010 0, 08 0,8 0,501-0, HR=2,0 HR2 (HR=2, 1,253, 3, 1,25-3 18,9x17, 189x (18,9x17 p= 24,27x27, 2427x (24,27x27 ( HR=1, (HR=1 1,0261 1,026- HR=0 (HR= 0,5010, 0,501-0 HR=2, (HR=2 1,253 1,25- 18,9x17 (18,9x1 24,27x27 (24,27x2 HR=1 HR= (HR 0,5010 0,501- HR=2 18,9x1 (18,9x 24,27x2 (24,27x 18,9x 24,27x