The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-Center Experience in China

Zhang, Xiaohui; Shou, Zhangfei; Chen, Zhimin; Xü, Ying; Han, Fei; Yin, Xiaoxing; Lin, Jun; Pan, Haiyan; He, Peipei; Chen, Jianghua

doi:10.3747/pdi.2013.00124

Cited by 9 publications

(13 citation statements)

References 14 publications

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“…Our technique survival rates were lower than those reported by Isla et al from the Limpopo province of South Africa [22] and from China and Canada [11,23,24], but are similar to those reported from the USA [16] and Mexico [25] ( Table 6). Most of these studies, including ours, reported survival in patients starting PD (from day 0).…”

Section: Discussionsupporting

confidence: 82%

“…Most of these studies, including ours, reported survival in patients starting PD (from day 0). However, the Mexican study [25] included only patients who had been established on PD for one month and one of the studies from China [24] included only patients who had been on PD for three months. We considered it * An informal dwelling (or "shack") is defined by Statistics South Africa [33] as a makeshift structure not approved by a local authority and not intended as a permanent dwelling.…”

Section: Discussionmentioning

confidence: 99%

“…The study by Cueto-Manzano [25] included only patients who had been on PD for at least one month and considered all deaths as technique failure. The study by Zhang [24] included only patients who had been on PD for at least three months.…”

Section: Discussionmentioning

confidence: 99%

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Peritoneal dialysis technique survival at Tygerberg Hospital in Cape Town, South Africa

Kapembwa

Bapoo

Tannor

et al. 2017

AJN

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Background: The use of peritoneal dialysis (PD) as a treatment modality for patients with end-stage renal disease (ESRD) has been declining in many countries over the past few years. One of the reasons is technique failure, which occurs more frequently than is the case with chronic haemodialysis. Identifying and addressing the causes of technique failure is important in order to maintain more patients on PD, especially in settings where there are limited resources for chronic haemodialysis and a "PD first" approach is followed. Methods: In this retrospective study at Tygerberg Hospital in Cape Town, South Africa, we investigated 170 patients who were started on chronic ambulatory PD between January 2008 and July 2014, and determined rates of technique and patient survival. Demographic, clinical and laboratory data were assessed to identify risk factors for these outcomes. Results: The median age of the patients was 36 years and the most common cause of ESRD was glomerulonephritis. Only one patient had diabetes mellitus. Technique survival at 1, 3 and 5 years was 80%, 54% and 39%, respectively, while patient survival was 90%, 82% and 63%. Patients started on PD during the second half of the study period had improved rates of technique survival. Peritonitis was the most common cause of technique failure. Increasing age and Black ethnicity were associated with increased likelihood of technique failure. Other clinical and social factors were not significantly associated with the occurrence of technique failure. Conclusions: In our patients on PD, peritonitis, increased age and Black ethnicity were important factors associated with the development of technique failure. Concerted efforts are required to reduce peritonitis rates at our centre as this is the leading cause of technique failure.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Peritoneal dialysis technique survival at Tygerberg Hospital in Cape Town, South Africa

Kapembwa

Bapoo

Tannor

et al. 2017

AJN

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“…Patients are encouraged to visit the dialysis facility regularly for routine management and to see the nephrologists. The suggested PDC interval for PD patients is 1-3 months in the United States and 1-6 months in China [13,18,19]. The optimal PDC interval and its impact on clinical outcomes for PD patients remain unknown.…”

Section: Discussionmentioning

confidence: 99%

Patient-Doctor Contact Interval and Clinical Outcomes in Continuous Ambulatory Peritoneal Dialysis Patients

Chen

Guo²,

Lin³

et al. 2017

Am J Nephrol

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Background: The optimal patient-doctor contact (PDC) interval remains unknown in peritoneal dialysis (PD) patients. The aim was to investigate the association between PDC interval and clinical outcomes in continuous ambulatory PD (CAPD) patients. Methods: In this retrospective cohort study, CAPD patients who resided in Guangzhou city between January 2006 and December 2012 were included. According to receiver operating characteristic curve analysis, all patients were classified as high (PDC interval ≤2 months) and low (PDC interval >2 months) PDC frequency groups. Biochemical data, clinical events, and clinical outcomes during the follow-up period were compared. Results: Of 433 CAPD patients, the mean age was 51.3 ± 15.7 years, 54.3% of patients were male, and 29.1% with diabetes. The median vintage of PD was 45.8 (26.3-69.1) months. Patients with high PDC frequency (n = 233) had better patient-survival rates (99.6, 87.7, and 76.5% vs. 92.7, 76.5, and 58.7% at 1, 3, and 5 years; p < 0.001), lower peritonitis rate (0.17 vs. 0.23 episodes per patient-year; p < 0.001), and hospitalization rate (0.49 vs. 0.67 episodes per patient-year; p < 0.001) than those in the low PDC frequency group (n = 200). After adjustment for confounders, PDC interval of no more than 2 months was independently associated with better patient survival (hazard ratio 0.60, 95% CI 0.42-0.86, p = 0.006). Conclusion: A PDC interval of 2 months or less was associated with better clinical outcomes in CAPD patients. This indicates that a shorter PDC interval should be encouraged for them to achieve better clinical outcomes.

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“…More detailed reasons behind the growth of PD in China are discussed in a separate section (below). University hospitals that already had a PD research background showed the fastest growth in their PD programs and reported outstanding clinical outcomes compared with less experienced centers (15)(16)(17)(18)(19). In papers S20 YAO et al…”

Section: Growth Of Chinese Pd Research Internationally and Locallymentioning

confidence: 99%

What pd Research in China Tells Us

Yao¹,

Dong

Feng³

et al. 2018

Perit Dial Int

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Peritoneal dialysis (PD) was introduced in China later than in most Western countries, and PD research activity was quite limited until the 1990s. However, in the 2000s, and even more so during the last decade, there has been an unsurpassed increase in the number of PD patients, paralleled by a substantial increase in PD research activity reflected by an increasing number of PD papers from China. In this brief review, we describe some of the factors that may explain the dramatic developments in PD research in mainland China, such as the focus on basic research using scientific approaches that subsequently could be applied also in clinical studies. Another important factor was the growing interactions with international PD research centers in Hong Kong and in Western countries. Thanks to strong support from Chinese national and regional funding sources, a growing number of young Chinese researchers went to key international PD centers to learn about novel advanced research techniques. This paved the way for long-lasting, productive collaborations with benefits also for the foreign host institutions. Finally, we present some current research projects, including basic research that may contribute to the understanding of mechanisms behind complications such as peritonitis, and clinical projects aiming at improving PD management guidelines and better understanding of the potential of PD in China. Because of the size of the PD population, now the largest in the world, and the increasing number, and quality, of researchers in the PD field, PD research in China is destined to be a major contributor to advancements in PD in the near future.

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The Role of an Integrated Care Model for Kidney Disease in the Development of Peritoneal Dialysis: A Single-Center Experience in China

Cited by 9 publications

References 14 publications

Peritoneal dialysis technique survival at Tygerberg Hospital in Cape Town, South Africa

Peritoneal dialysis technique survival at Tygerberg Hospital in Cape Town, South Africa

Patient-Doctor Contact Interval and Clinical Outcomes in Continuous Ambulatory Peritoneal Dialysis Patients

What pd Research in China Tells Us

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