Urgent-Start Peritoneal Dialysis: Opening New Door for ESRD Patients Undergoing CABG

A 56 year old male with past medical history (PMH) of chronic kidney disease (CKD) Stage V due to IgA nephropathy, hypertension (HTN) and diabetes mellitus (DM) type 2 (II) presented with chest pain. The glomerular filtration rate (GFR) on presentation was 5 ml/ min. The patient was started on urgent- start peritoneal dialysis (PD). In the meantime, he was evaluated by cardiology, underwent immediate angiography and was found to have triple-vessel disease. Subsequently, it was decided that he needed an urgent coronary artery bypass surgery (CABG). The general practice is to place the patient on hemodialysis (HD) for optimizing the fluid and electrolytes balance before an urgent CABG, but it was for the first time that we opted to keep the patient on PD and proceed with the surgery. The patient had no post-op complications and extubated within 24 hours of the surgery.