French peritoneal dialysis registry (RDPLF): Outline and main results

Abstract

The Registre de Dialyse Péritonéale de Langue Française (RDPLF Registry) is a non-profit association that has been set up to assist physicians and nurses in evaluating their practical experience and results regarding peritoneal dialysis (PD). Five French-speaking and two Spanish-speaking countries have participated in this initiative (which includes 21 000 patients). In France, 82% of all PD patients are included in the registry and the main results for the period from 1995 to January 2006 form the basis of this report: of 11 744 incident patients with a median age of 71 years, 21.5% were over 80 years of age and 56% were not able to perform PD treatment at home without assistance. Eighty-six percent of the latter group received external assistance from a private nurse and 14% were aided by their family. The overall average rate of peritonitis was one episode every 29 months. The probability of being peritonitis-free appeared to be better for patients on automated PD (59.4% at 2 year) than for those on continuous ambulatory PD (55.3%), but this finding requires further validation. The average waiting time before transplantation was about 2 years. In patients who had undergone transplantation, the peritonitis rate was one episode per 42 months before transplantation compared to one episode per 29 months for patients who had not received a transplant. Eighty-three percent of patients had a hemoglobin level greater than 11 g%. Catheter survival was 92% at 2 years post-insertion and 85% at 5 years, with 94% being implanted by experienced surgeons. In conclusion, the RDPLF results demonstrate that PD may be successfully prescribed for older patients who receive assistance either from their family or from a nurse. Further, a larger number of younger patients should also be prescribed this technique in France. Patients eligible for transplantation and on short-term PD have the lowest risk of developing peritonitis; PD before transplantation may help prolong residual renal function, and initial treatment by PD may also help to preserve vascular access for the future.

Better Outcomes of Peritoneal Dialysis in Diabetic Patients in Spite of Risk of Loss of Autonomy for Home Dialysis

“…Focusing on a population that mimics the average age of our treated patients, in the French PD registry, DM patients aged 50 -60 years had lower three-year patient and technique survivals, reported as 59% and 34%, respectively (10). Better results are achievable with contemporary PD prescription (11).…”

Assisted Peritoneal Dialysis for Older People with End-Stage Renal Disease: The French and Danish Experience

“…Regarding clinical outcomes, we have previously reported (20) that aAPD patients, compared with older (> 65 years) autonomous PD patients, in our care have the same PD technique survival rate but an inferior patient-and peritonitis-free-survival rate, which corresponds to the experience from France (17,22). This difference persists even after adjustment for differences in basic demographics, age, and comorbidity and indicates that dependency on help per se, not surprisingly, is an independent risk factor for a poorer prognosis.…”

“…No special nurse's legal qualification in PD is required. Assisted PD is largely used in the older population (7,17). In 2006, 21.5% of the incident PD patients were over 80 years of age.…”

The Effect of Demographical and Social Parameters on Patient Survey in Peritoneal Dialysis Patients

“…PD'nin klinik sonuçları merkezin PD tecrübe düzeyi, genetik faktörler, yaş, komorbit hastalık (hipertansiyon, diabetes mellitus), kardiyovasküler risk faktörleri, beslenme durumları, rezidual renal fonksiyon, peritonit hızı, serum kreatinin, serum albumin düzeyi, total Kt/V üre, D/P kreatinin, membran transport özelliğine bağlı olarak değişebilmektedir (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Bizim çalışmamızın sonuçları ise eğitim düzeyi, yaş, kreatinin ve albumin düzeyinin hasta sağ kalımını etkilediğini göstermektedir.…”