Background: Urgent-start peritoneal dialysis (UPD) has emerged as an alternative modality for initiating kidney replacement therapy when immediate hemodialysis is not available. However, early initiation after catheter placement may increase the risk of mechanical complications. Evidence from real-world settings, particularly in resource-limited healthcare systems, remains limited. Objective: To determine the frequency of early complications associated with urgent-start peritoneal dialysis and to identify clinical factors associated with their occurrence. Methods: We conducted a prospective observational cohort study including adult patients with chronic kidney disease who initiated peritoneal dialysis within 14 days after catheter placement at a public hospital in Mexico. Patients were followed for 30 days after dialysis initiation. The primary outcome was the occurrence of any dialysis-related complication within 30 days after initiation of peritoneal dialysis. Comparisons were performed according to dialysis initiation timing (<72 h vs. ≥72 h). Multivariable logistic regression was used to identify independent predictors of complications. Results: Sixty-five patients were included, of whom 29 (44.6%) developed complications within the first 30 days. Mechanical complications predominated, particularly pericatheter leakage (18.5%) and drainage failure (10.8%). Patients who initiated dialysis within 72 h after catheter placement experienced a significantly higher complication rate. In multivariable analysis, initiation of peritoneal dialysis within <72 h remained independently associated with complications (OR 5.75, 95% CI 1.06–31.29, p = 0.043). Conclusions: Initiating peritoneal dialysis within 72 h after catheter placement was associated with a significantly increased risk of early complications. When clinically feasible, delaying dialysis initiation beyond 72 h may reduce mechanical complications in urgent-start peritoneal dialysis programs.

Background: Early identification of patients requiring operative management (OM) after blunt abdominal trauma is critical, yet initial physiological signs may be nonspecific. We sought to develop and internally validate an admission-based prediction model for early emergency department (ED) triage, prior to computed tomography (CT), using routinely available physiological and biochemical parameters. Methods: We conducted a retrospective observational study including adult patients with blunt abdominal trauma who underwent FAST and lactate testing at admission. OM was defined as any abdominal surgical intervention within 24 h to control hemorrhage or repair injury. A multivariable logistic regression model incorporating lactate, heart rate, leukocyte count, and FAST positivity was developed using complete-case data. Lactate diagnostic accuracy was assessed using ROC analysis. Internal validation was performed with 1000 bootstrap resamples. Results: In 81 patients with lactate results, lactate showed good discrimination for OM (AUC 0.815). At ≥3.5 mmol/L, sensitivity was 0.737 (95% CI 0.569–0.866), specificity 0.744 (0.588–0.865), LR⁺ 2.88, and LR⁻ 0.35. The final logistic model demonstrated an apparent AUC of 0.904 and an optimism-corrected AUC of 0.882. The full model equation and coefficients are provided for reproducibility. Conclusions: Admission lactate, combined with FAST and physiologic measurements, provides useful early-triage information before CT and warrants external validation in larger cohorts.