Analysis of the factors conditioning the diffusion of peritoneal dialysis in Italy

Abstract

Results. The percentages on PD of total incident (Inc PD %) and prevalent dialysis patients (Prev PD %) were 15.9% and 10.3%, respectively with considerable variations from region to region and from centre to centre. The Inc PD % was higher in regions with fewer patients on dialysis in private centres. In the private centres, the Inc PD % was 0.4%. Of the 325 nonpaediatric public centres, 116 (35.7%) do not use PD: compared with the 209 centres which do, these centres have a lower mean Inc HD þ PD and Prev HD þ PD per centre (13.0 AE 12.3 vs 28.6 AE 18.0 À 51.8 AE 35.7 vs 117.3 AE 66.4 patients, P < 0.0001), and more haemodialysis (HD) stations available (3.0 vs 3.5 patients per HD station, P < 0.0001). However, the significant influence of cultural and motivational factors on the use of this method is demonstrated by the fact that it is used by 34% of the smaller non-paediatric public centres, and is not used by 19% of the larger nonpediatric public centres.

Epidemiology of peritoneal dialysis: a story of believers and nonbelievers

“…in France, 14% of all patients who received dialysis between 2002 and 2005 started on peritoneal dialysis; however, this rate varied significantly across districts, ranging between 0% and 45%. 12 the same within-country differences have been observed in italy 13 and spain. 7 in spain, three neighboring regions had wide variations in the utiliza tion rates of peritoneal dialysis and hemodialysis-peritoneal dialysis was widely used in Basque regions whereas Catalonia had a rather low rate of peritoneal dialysis use.…”

Theory and Reality in the Selection of Peritoneal Dialysis

“…I n the West, the choice of peritoneal dialysis (PD) tends to be limited and extremely variable from country to country, as is shown by the incidence data recorded in dialysis registries (1,2) (Figure 1). This variability is also found between different geographical areas within countries (2-4) and from center to center, as highlighted in particular by the work of Couchoud et al in France (3), in this issue of Peritoneal Dialysis International , and by recent publications by Kutner in the USA (5) and Viglino in Italy (4). Indeed, Kutner (5) reports that only 45.2% of 4177 centers in the USA offer PD, and Viglino that the incidence of PD in the non-pediatric public centers where it is performed (64.3%) varies from 3.1% to 82.3% (4).…”

Peritoneal Dialysis use within the Context of the Population and Healthcare Systems of Europe -Differences, Trends and Future Challenges

“…In the 7 regions with no private centres and in the 8 regions with <10% patients on dialysis in private centres, the incident PD rate is 23.2% and 18.0% respectively. In the remaining regions with >10% of patients on dialysis in private centres, the rate of PD usage is only 9.5% (32). Of note, in Germany the reimbursement system changed to incentivise PD and now this modality is effectively reimbursed on a higher level compared to HD, but this has not influenced PD utilization, placing it on one of the lowest levels in Europe (33).…”