Viability of Home Peritoneal Dialysis: Experience with 100 Patients from an Arab Population

Abstract

Background The viability of home peritoneal dialysis (HPD) is being debated in Arab countries. We therefore undertook the present study to assess the viability of HPD in the Arab culture. Patients and Methods A total of 100 patients with end-stage renal failure were treated with HPD during the period January 1996 to October 2001. Results Continuous ambulatory peritoneal dialysis (CAPD) was performed in 81 patients (81%), and nightly intermittent peritoneal dialysis (NIPD) in 19 patients (19%). The patient group included 54 men (54%) and 46 women (46%) with a mean age of 54.94 ± 14.58 years. They were followed for a total of 2118.3 patient–treatment months and had a mean dialysis duration of 21.2 ± 9.97 months. Peritonitis occurred at the rates of 1 episode every 18.5 patient–treatment months (Bieffe L3 double-bag system: Bieffe Medital, Grosotto, Italy), 1 episode every 22.5 patient–treatment months (ANDY Plus system: Fresenius Medical Care, Bad Homburg, Germany), and 1 episode every 23.7 patient–treatment months (NIPD system Fresenius PD-Night: Fresenius Medical Care, Bad Homburg, Germany). Recurrent peritonitis was the main reason (70.6%) for transfer to hemodialysis. A good level of social well-being and rehabilitation was achieved in 49 patients on CAPD (60.5%) and 13 patients on NIPD (68.4%). Conclusions We conclude that HPD is a viable modality of renal replacement therapy in Arab countries. By adopting a strict training model, the peritoneal dialysis team can train even patients or caregivers with limited education, preventing peritonitis and promoting the general well-being of patients.

Outcome and Survival in Different Peritoneal Dialysis Modalities

“…Additionally, use of recently introduced tubing and connectors in our unit have played a major role in reducing the peritonitis rate. Previously we had reported one peritonitis episode per 18.5 patient treatment months compared with one episode per 22.5 patient treatment months in users of the Bieffe L3 and ANDY Plus systems, respectively (15).…”

A Systematic Review and Jurisdictional Scan of the Evidence Characterizing and Evaluating Assisted Peritoneal Dialysis Models

“…In general, there is a core set of procedural assistance that can be provided by all PD assistants in the characterized models (dark blue box, Figure 2) (45). Home assistants, with the support of patient's family, are trained to provide the most basic assistance with the operation of the PD machine, including machine set-up and dismantling, machine connections, PD bag exchange, and ordering and disposal of PD supplies (46)(47)(48)(49)(50)(51)(52). Home assistants can also provide social support and assistance with activities of daily living (45).…”

“…This model was identified in six jurisdictions: China (46), Kuwait (47), Saudi Arabia (48), Singapore (49), Taiwan (50,51), and Portugal (52). Typically, home assistants received assisted PD training through in-hospital programs or dialysis clinics (46)(47)(48)(49)(50)(51). In all jurisdictions, patients' family members or informal caregivers also provide supplemental assistance for PD, and so undergo the same assisted PD training as home assistants.…”

“…Given this coordinated support, there are no fixed number of visits described for this assisted PD model. Assistance for both the automated PD and continuous ambulatory PD procedures were also provided (46)(47)(48)(49)(50)(51)(52).…”