The Evolving Practice of Nephrology During the COVID-19 Pandemic in Brunei Darussalam

Lim, Chiao Yuen; Lim, Yee Yin; Tan, Jackson

doi:10.1016/j.ekir.2021.10.003

Cited by 2 publications

(2 citation statements)

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“…The total health care expenditure was 2% of gross domestic product in 2018 (7). Approximately 5–10% of the health care budget is spent on providing dialysis care (8). In line with the expected expansion of the future dialysis population, it is predicted that >20% of health care budget may be taken up for dialysis by 2035 (Figure 2).…”

Section: Health Care Funding and Dialysis Subsidiesmentioning

confidence: 99%

Global Dialysis Perspective: Brunei Darussalam

Lim

Tan

2021

Kidney360

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Section: Health Care Funding and Dialysis Subsidiesmentioning

confidence: 99%

Global Dialysis Perspective: Brunei Darussalam

Lim

Tan

2021

Kidney360

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“…1 However, despite this, the PD penetrance has remained static for past few years, until recently during the pandemic, where successful initiatives were lobbied on the government to increase PD uptake. 2 As of end of 2021, the PD penetrance has increased to 13.5% and is continuing to grow. A successful PD program not only needs to overcome barriers to increase PD uptake but also needs to keep patients on the therapy for as long as possible.…”

Section: Introductionmentioning

confidence: 99%

A Nationwide Comparative Analysis of Peritoneoscopic and Laparoscopic Techniques for Peritoneal Dialysis Catheter Insertion in Brunei Darussalam

Lim

Rajput

et al. 2022

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Background: Brunei Darussalam introduced peritoneoscopic insertion of peritoneal dialysis catheter (PDC) as a new method in 2014. The aim of this study was to compare outcomes of PDC insertion technique in the country, using proposed standardized definitions of outcomes. Methods: This study used retrospective analysis of all PDC inserted from 1st January 2015 to 31st December 2020 in the country. Outcomes of both peritoneoscopic and laparoscopic insertion methods were analyzed. Four main categories of outcomes were assessed - 1) operative-related outcomes, 2) infective outcomes, 3) mechanical outcomes and 4) time on PD therapy. Results: During the study period, 145 PDC were inserted. 49 (33.8%) were by peritoneoscopy and 96 (66.2%) laparoscopy. The median time on PD therapy was 54.2 months. Those with a higher BMI and history of previous abdominal or pelvic surgery were more likely to undergo laparoscopic method. There was no significant difference in overall infective and mechanical outcomes between the two methods. There was however significantly more post-operative pain observed in the peritoneoscopic group than in the laparoscopic group (8.2% vs 1.0%, p = 0.045). During the study period, there were 49 dropouts to HD, about half were due to infection. However, there was no statistically significant difference observed in time on PD therapy between the two groups (HR 0.87 in laparoscopic group compared to peritoneoscopic group, 95% CI 0.49 to 1.54; p = 0.636). Conclusions: Peritoneoscopic and laparoscopic PD catheter insertions are both complementary to each other in our local setting. This study has enabled us to scrutinize our PD program, with regards to our PDC insertion experience, with the aim to sustain PD growth in the country.

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The Evolving Practice of Nephrology During the COVID-19 Pandemic in Brunei Darussalam

Cited by 2 publications

References 3 publications

Global Dialysis Perspective: Brunei Darussalam

Global Dialysis Perspective: Brunei Darussalam

A Nationwide Comparative Analysis of Peritoneoscopic and Laparoscopic Techniques for Peritoneal Dialysis Catheter Insertion in Brunei Darussalam

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