대한신장학회

논문분류	춘계학술대회 초록집
제목	Exploring the Effectiveness of Acute Incremental Peritoneal Dialysis Case Management on Cardiorenal Syndrome
저자	Shan-Yu Hsu
출판정보	2026; 2026(1):
키워드	Peritoneal dialysis, incremental peritoneal dialysis, urgent‑start peritoneal dialysis, case management,, patient perspective
초록	Case Study: Background Cardiorenal syndrome is frequently observed in patients with concomitant heart failure and chronic kidney disease, often requiring urgent initiation of renal replacement therapy. Incremental peritoneal dialysis (PD), characterized by a stepwise increase in dialysis volume, may reduce physiological burden and enhance patient adaptation during the acute phase. This study aimed to evaluate the clinical outcomes of urgent‑start incremental PD combined with case management and to explore the experiences of patients and family caregivers. Methods This qualitative study included patients who initiated PD within 24–72 hours after catheter insertion and subsequently transitioned to routine therapy. Has never undergone hemodialysis. Six patients and six primary family caregivers were enrolled. Data collection included semi‑structured interviews, biochemical indicators, and retrospective review of medical and nursing records. Thematic content analysis was applied to identify major care needs and adaptation experiences. Results Following case‑management intervention and incremental PD, improvements were observed in creatinine, BUN, and and stable Kt/V. One case demonstrated an improvement in ejection fraction from 27% to 45%, and notable enhancement in cardiac function (EF) after incremental PD . All patients remained clinically stable without catheter leakage or procedure‑related complications and successfully transitioned to long‑term PD. Thematic analysis identified five domains: emotional reactions to initiating PD, caregiver burden, challenges in mastering exchange techniques, physical adaptation, and needs for care coordination and informational support. Conclusion Urgent‑start incremental PD combined with structured case management enhances treatment acceptance, reduces anxiety, improves technical confidence, and supports a safe transition to long‑term PD in patients with cardiorenal syndrome. The findings suggest favorable clinical feasibility, warranting larger multi‑center studies to further validate long‑term outcomes.
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