Peritoneal Dialysis Guidelines 2019 Part 1 (Position paper of the Japanese Society for Dialysis Therapy)

Abstract

Approximately 10 years have passed since the Peritoneal Dialysis Guidelines were formulated in 2009. Much evidence has been reported during the succeeding years, which were not taken into consideration in the previous guidelines, e.g., the next peritoneal dialysis PD trial of encapsulating peritoneal sclerosis (EPS) in Japan, the significance of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), the effects of icodextrin solution, new developments in peritoneal pathology, and a new international recommendation on a proposal for exit-site management. It is essential to incorporate these new developments into the new clinical practice guidelines. Meanwhile, the process of creating such guidelines has changed dramatically worldwide and differs from the process of creating what were “clinical practice guides.” For this revision, we not only conducted systematic reviews using global standard methods but also decided to adopt a two-part structure to create a reference tool, which could be used widely by the society’s members attending a variety of patients. Through a working group consensus, it was decided that Part 1 would present conventional descriptions and Part 2 would pose clinical questions (CQs) in a systematic review format. Thus, Part 1 vastly covers PD that would satisfy the requirements of the members of the Japanese Society for Dialysis Therapy (JSDT). This article is the duplicated publication from the Japanese version of the guidelines and has been reproduced with permission from the JSDT.

Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection

“…Finally, it can be due to the attending doctors’ preconceived notions of which dialysis modality is appropriate for the patient. Because of the significant effect of residual renal function on prognosis in patients undergoing PD, patients who select PD are recommended to initiate dialysis earlier compared with those who select HD: Attending nephrologists may have implemented RRT education by nurse specialists with time to spare for patients who they subjectively judged to be suitable for PD [ 34 ]. The large variation in the timing of RRT education with the same doctors, and the low rates of PD selection when RRT education was provided by nephrologists themselves in this study, might reflect this preconception.…”

Perioperative Management and Surgical Outcomes of Colorectal Cancer Patients Undergoing Peritoneal Dialysis for End-Stage Kidney Disease

“…Peritoneal degeneration and encapsulating peritoneal sclerosis are linked to the length of PD and a history of PD-related peritonitis [ 10 ]. Furthermore, due to excess fluid and protein loss in the dialysate, patients with PD are prone to malnutrition, which impairs wound healing [ 10 ], and bowel resection in patients with chronic renal failure has been linked to an increased risk of mortality [ 11 ]. Laparoscopic colorectal cancer surgery was shown to be feasible and safe in the majority of instances in the present investigation.…”

Changes in erythropoiesis‐stimulating agent responsiveness after transfer to combined therapy with peritoneal dialysis and hemodialysis for patients on peritoneal dialysis: A prospective multicenter study in Japan

“…Patients on PD received ESA by subcutaneous injection, and those on combined therapy received ESA via intravenous injection. Although the dose of ESA were adjusted according to guidelines [13,14], the decision were left to treating physicians.…”