Theory and Reality in the Selection of Peritoneal Dialysis

Viglino, Giusto; Neri, Loris

doi:10.1177/089686080802800510

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…As for the causes of transfer from PD to HD, peritonitis (30%) and inadequate dialysis (30%) were the most frequent reasons in our study. These numbers were similar to those reported by Viglino and Neri, who revealed peritonitis (30% -40%), dialysis inadequacy (11% -27%), and subsequent inability and/or choice (10% -32%) as the most frequent reasons for technique failure (28).…”

Section: Discussionsupporting

confidence: 90%

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

et al. 2009

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Background There are no Taiwanese publications and only a few Asian publications on the long-term outcome of peritoneal dialysis (PD) patients. The aim of this study was to evaluate the outcome of PD patients in Taiwan during a 7-year follow-up period. Patients and Methods This study enrolled 67 patients (23 males, mean age 46.2 ± 14.5 years) on maintenance PD. We administered the Short-Form questionnaire on 30 September 1998 and recorded major events and outcomes until 30 September 2005. We compared differences in initial parameters between groups categorized by PD patient survival and PD technique survival. Causes of mortality and transfer to hemodialysis were determined. PD patient and PD technique survival rates were measured and risk factors for patient mortality and PD technique failure were analyzed. Results Those in patient survival or PD technique survival groups had lower mean age ( p < 0.001 and 0.018 respectively) and higher serum albumin level ( p = 0.015 and 0.041 respectively) compared to those that died or failed PD. The 7-year patient survival rate was 77% and the PD technique survival rate was 58%. The independent predictors for PD technique failure included lower Mental Component Summary scores [hazard ratio (HR) = 0.85, p = 0.031] and diabetes mellitus (HR = 4.63, p < 0.001), whereas lower serum albumin level (HR = 0.22, p = 0.031), lower Physical Component Summary scores (HR = 0.67, p = 0.047), and presence of diabetes mellitus (HR = 5.123, p = 0.009) were the independent predictors for patient mortality. Conclusion For our PD patients, both patient and technique survival rates are good. Better glycemic control, adequate nutrition, and enhancement of health-related quality of life are all of potential prognostic benefit.

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Section: Discussionsupporting

confidence: 90%

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

et al. 2009

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“…In the centers using PD, we noted considerable variability in the use of that modality from center to center in both periods, confirming that the infrequent use of PD is not linked to clinical or social grounds, but rather to other factors analyzed previously—for example, the status of the center as public or private, the availability of HD beds, and the size of the center (1,5).…”

Section: Discussionsupporting

confidence: 78%

Old and New Perspectives on Peritoneal Dialysis in Italy Emerging from the Peritoneal Dialysis Study Group Census

et al. 2012

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BackgroundTo understand how peritoneal dialysis (PD) was being used in Italy in 2005 and 2008, a census of all centers was carried out.MethodsIn 2005 and 2008, data were collected from, respectively, 222 and 223 centers, with respect to 4432 and 4094 prevalent patients.ResultsIn the two periods, the PD incidence remained stable (24.3% vs 22.9%), varying from center to center. Continuous ambulatory PD (CAPD) was the main initial method (55%), but APD was more widespread among prevalent patients (53%). Among patients returning to dialysis from transplantation (Tx), PD was used in 10%. The use of incremental CAPD increased significantly from 2005 to 2008, in terms both of the number of centers (27.0% vs 40.9%) and of patients (13.6% vs 25.7%). Late referrals remained stable at 28%, with less use of PD. The overall drop-out rate (episodes/100 patient–years) remained unchanged (31.0 vs 32.8), with 13.1 and 12.9 being the result of death, and 11.8 and 12.4 being the result of a switch to hemodialysis, mainly after peritonitis. A dialysis partner was required by 21.8% of the PD patients. The incidence of peritonitis was 1 episode in 36.5 and 41.1 patient–months, with negative cultures occurring in 17.1% of cases in both periods. The incidence of encapsulating peritoneal sclerosis (episodes/100 patient–years) was 0.70, representing 1.26% of patients treated. The catheter types used and the sites and methods of insertion varied widely from center to center.ConclusionsThese censuses confirm the good results of PD in Italy, and provide insight into little-known aspects such as the use of incremental PD, the presence of a dialysis partner, and the incidence of encapsulating peritoneal sclerosis.

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“…[19] The first domain was related to PD and HD eligibility assessment by looking for contraindications or barriers for both modalities already defined in the medical literature. [15][16][17][18][19] A research nephrologist (KS), independent of the nephrology department, reviewed and collected clinical and sociodemographic information from each participant's clinical records.…”

Section: Methodsmentioning

confidence: 99%

“…*Bibliographic references. [15][16][17][18][19] HD = hemodialysis, PD = peritoneal dialysis. www.md-journal.com modalities was provided.…”

Section: Methodsmentioning

confidence: 99%

“…[ 15 ] The percentage of contraindications reported for PD varies between 17% and 28% of patients. [ 10 , 16 ] This variability may be explained by the fact that some authors include non-clinical contraindications for PD in their calculations, whereas others consider such features as barriers, but no contraindications. [ 17 – 19 ] There is still insufficient high-level evidence to recommend one therapy over another.…”

Section: Introductionmentioning

confidence: 99%

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Appropriateness of the dialysis modality selection process: A cross-sectional study

2022

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Studies that specifically quantify the appropriateness of the process of dialysis modality selection are lacking. Peritoneal dialysis (PD) offers clinical and social advantages over hemodialysis (HD), but may be underused. We aimed to determine the appropriateness of the process of dialysis modality selection and quantify the percentage of patients who could potentially have been PD candidates. We performed a cross-sectional study that included adult patients from a hospital Nephrology Department in Barcelona who started dialysis between 2014 and 2015. We assessed the appropriateness of dialysis modalities selection by defining 3 sequential domains based on 3 critical steps in choosing a dialysis modality: eligibility for either treatment, information about modalities, and shared decision-making. We obtained data using medical records and a patient questionnaire. The dialysis modality selection process was considered appropriate when patients had no contraindications for the selected option, received complete information about both modalities, and voluntarily chose the selected option. A total of 141 patients were included in this study. The median age was 72 years (interquartile range 63–82 years), and 65% of the patients were men. The dialysis modality selection process was potentially inappropriate in 22% of the participants because of problems related to information about dialysis modalities (15%) or shared decision-making (7%). Appropriate PD use can potentially increase from 17% to 38%. Patient age and lack of information regarding dialysis options were independently associated with the potential degree of inappropriate dialysis modality selection. Our findings indicate areas for improvement in the selection of dialysis modalities. With better education and shared decision-making, the number of patients with PD could potentially double. The analysis of appropriateness is a helpful approach for studying renal replacement treatment patterns and identifying strategies to optimize their use.

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Theory and Reality in the Selection of Peritoneal Dialysis

Cited by 7 publications

References 22 publications

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

Old and New Perspectives on Peritoneal Dialysis in Italy Emerging from the Peritoneal Dialysis Study Group Census

Appropriateness of the dialysis modality selection process: A cross-sectional study

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