scholarly journals Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability

2021 ◽  
pp. 089686082110498
Author(s):  
Anita van Eck van der Sluijs ◽  
Brigit C van Jaarsveld ◽  
Jennifer Allen ◽  
Karmela Altabas ◽  
Clémence Béchade ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Practice Variation ◽  
Dialysis Patients ◽  
Home Dialysis ◽  
Factors Associated ◽  
Western European ◽  
End Stage ◽  
Dedicated Team

Background: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. Methods: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. Results: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07–10.68), non-academic centres (OR: 2.01; 95% CI: 1.09–3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35–6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was <10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of >30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21–3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76–4.47) of patients on home dialysis. Conclusions: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.[Formula: see text]

The Use of Community Nurses for Home Peritoneal Dialysis: Is it Cost -Effective?

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 479-482 ◽  
Author(s):  
Gillian Brunier ◽  
Barbara Gray ◽  
Nancy Coulis ◽  
Judy Savage ◽  
Arif Manuel ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Family Members ◽  
Cost Effective ◽  
Peritoneal Dialysis Patient ◽  
Severe Disabilities ◽  
Dialysis Patients ◽  
Home Dialysis ◽  
Complex Needs ◽  
Stage Renal Disease ◽  
End Stage

In the late 1970s, continuous ambulatory peritoneal dialysis was first introduced as a mode of treatment for patients with end-stage renal disease. Since that time many patients, themselves or with the help of family members, have routinely performed the therapy at home. There are now 2935 home peritoneal dialysis patients in Canada (36% of the total dialysis population}. Today, however, the average patient on dialysis is likely to be older and have other complicating illnesses; moreover, patients may live alone, or have family members who are working. Over the past three years, through the use of innovative assistive devices and strong educational links with community nursing agencies, we have been able to manage peritoneal dialysis patients with complex needs in the home. We performed a retrospective analysis of 18 patients, with severe comorbid conditions, who were managed in the home with the help of community nurses. We will show that this is an economic, efficient, and effective method of caring for home dialysis patients with severe disabilities. Home care agencies need our support so that they can continue to help us manage the complex peritoneal dialysis patient in the 1990s.

scholarly journals Biological basis of hypoalbuminemia in ESRD.

1998 ◽  
Vol 9 (12) ◽  
pp. 2368-2376 ◽  
Author(s):  
G A Kaysen
Keyword(s):  
Peritoneal Dialysis ◽  
Acute Phase ◽  
Synthesis Rate ◽  
Albumin Concentration ◽  
Albumin Synthesis ◽  
Dialysis Patients ◽  
Extravascular Space ◽  
Amyloid A ◽  
Stage Renal Disease ◽  
End Stage

Hypoalbuminemia is associated with mortality in patients with end-stage renal disease (ESRD) maintained either on peritoneal dialysis (PD) or hemodialysis (HD). Serum albumin concentration is determined by its rate of synthesis, by the catabolic rate constant (the fraction of the vascular pool catabolized per unit time), by external losses, and by redistribution from the vascular to the extravascular space. Hypoalbuminemia in dialysis patients is primarily a consequence of reduced albumin synthesis rate in both HD and PD patients, and in the case of PD patents, of transperitoneal albumin losses as well. Continuous ambulatory peritoneal dialysis patients are able to increase albumin synthesis to replace losses. Thus, ESRD does not directly suppress albumin synthesis. The rate of albumin synthesis is inversely proportional to the serum concentration of one potential acute phase protein (alpha2 macroglobulin), and albumin concentration is inversely proportional to that of either C-reactive protein or serum amyloid A in both HD and PD patients. The cause of decreased albumin synthesis is primarily a response to inflammation (the acute phase response), although it is possible that inadequate nutrition may also contribute. The cause of the inflammatory response is not immediately evident. There is no evidence that shifts of albumin to the extravascular space or that dilution of the plasma by volume expansion plays any role in causing hypoalbuminemia in ESRD patients.

scholarly journals Counteracting the Metabolic Effects of Glucose Load in Peritoneal Dialysis Patients; an Exercise-Based Approach

2019 ◽  
Vol 48 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Sana F. Khan ◽  
Claudio Ronco ◽  
Mitchell H. Rosner
Keyword(s):  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Glucose Absorption ◽  
Metabolic Effects ◽  
Glucose Load ◽  
Dialysis Patients ◽  
Metabolic Complications ◽  
Positive Effects ◽  
Stage Renal Disease ◽  
End Stage

Glucose-based peritoneal dialysis (PD) solutions are the predominantly used dialysate in PD patients. Glucose absorption has been shown to be associated with several unfavorable metabolic complications. Several studies have shown positive effects of exercise in end-stage renal disease patients. This paper provides an overview of glucose-associated metabolic complications, and proposed exercise regimens to counteract the caloric load associated with glucose absorption.

A Retrospective Assessment of Risk Factors for Peritonitis among An Urban Capd Population

1993 ◽  
Vol 13 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Stephen M. Korbet ◽  
Edward F. Vonesh ◽  
Catherine A. Firanek
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Potential Risk ◽  
Infection Rates ◽  
Dialysis Patients ◽  
Level Of Education ◽  
Poisson Regression Analysis ◽  
Factors Associated ◽  
Retrospective Assessment ◽  
Potential Risk Factors

Peritonitis is a major reason why patients transfer from peritoneal dialysis (PD) to hemodialysis. We evaluated the peritonitis infection rates In 146 peritoneal dialysis patients who underwent dialysis at our facility between 1 January 1981 and 31 December 1989. Peritonit Is was the primary cause for changing treatment, with 24 (16.4%) of the patients transferring because of this complication. This represented 54.5% of all patients discontinuing CAPD due to method failure. A gamma-Poisson regression analysis was performed in an attempt to Identify potential risk factors associated with an increased Incidence of peritonitis. The results indicated that race, education level, and PD system used were significantly associated with the rate at which peritonitis occurred in our patient population. There was an almost twofold increase in the rate of peritonitis among blacks as compared to whites (2.2 vs 1.2 episodes/patient year). The level of education completed at the start of dialysis had a negative correlation with peritonitis rates. Patients with ≤8, 9–12, and ≥13 years of education had peritonitis rates of 2.4, 1.8, and 1.2 episodes/patient year, respectively. Finally, the system used had a significant effect with our patients on CCPD having lower peritonitis rates as compared to patients on either a connect or disconnect system (0.6 vs 2.5 vs 1.8 episodes/patient year, respectively). Recognizing potential risk factors for peritonitis will help us better understand and address this significant problem in our PD programs. Reducing peritonitis rates should facilitate a decrease in patient transfer due to method failure.

scholarly journals P1229PREVALENCE OF LIPID DISORDERS IN PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Safa Fattoum ◽  
Barbouch Samia ◽  
Hajji Mariem ◽  
Tasnim Mesbahi ◽  
Braiek Nessrine ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Ldl Cholesterol ◽  
Average Duration ◽  
Hdl Cholesterol ◽  
Dialysis Patients ◽  
Lipid Disorders ◽  
Renal Replacement Therapies ◽  
Average Serum ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Lipid disorders are common in end stage renal disease patients. Renal replacement therapies and especially peritoneal dialysis (PD) results in further alteration rather than correction of lipidemia. The aim of this study is to precise the prevalence of the different lipid disorders of PD patients. Method It’s a retrospective study conducted in our PD unit in December 2019. We collected all data concerning clinical characteristics of all patients currently in PD, as well as incidence of different lipid disorders. Results There were 90 patients with an average age of 45 years (extremes: 20.5 years and 80.6 years). The sex ratio is 1.25. Fourteen were diabetic (15.5%). All patients were on Automated PD (APD) except one on Continuous Ambulatory PD (CAPD). The average duration of PD was 40.5 months. The causal nephropathy was glomerular in 26,6 % (diabetic in 14 patients (15,5%)), hypertensive 13,3%,, interstitial in 16,66%., and undetermined in 27,7%. The average Charlson score was 3,2. The average serum level of total cholesterol (TC) was 4,96 mmol/L, of triglycerides (TG) was 1,7mmol/L, of HDL-cholesterol(HDLc) was 0,93 mmol/L, and of LDL-cholesterol(LDLc) was 3,05 mmol/L. Fifty one patients had dyslipidaemia: 13 had isolated hypercholesterolemia, 19 had isolated hypertriglyceridemia, and 19 had hypercholesterolemia and hypertriglyceridemia. All dyslipidemic patients were on hypolipemic diet. Twelve (13,3%) were taking statin, no one was taking fibrate. Conclusion Chronic dialysis patients have several cardiovascular risk factors due to renal failure and comorbidities often associated. Dyslipidemia is a modifiable risk factor. It must be screened and treated to reduce morbidity and mortality.

Nonclinical Factors Associated with Treatment with Peritoneal Dialysis in Esrd Patients in Taiwan

2010 ◽  
Vol 30 (6) ◽  
pp. 638-643 ◽  
Author(s):  
Hsiu-Chen Huang ◽  
Jiun-Yi Wang ◽  
Chia-Chu Chang ◽  
Ping-Fang Chiu ◽  
Ming-Che Chiang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Family Support ◽  
Univariate Analysis ◽  
Healthcare Providers ◽  
Early Referral ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
To Receive ◽  
Esrd Patients

ObjectivesLess than 10% of end-stage renal disease (ESRD) patients in Taiwan receive peritoneal dialysis (PD), which reveals the situation of underutilization of PD. We thus aimed to investigate factors associated with treatment with PD in ESRD patients in Taiwan.PatientsPatients that were 18 years of age or older and had been on dialysis for at least 3 months since 2001 were recruited and interviewed with a structured questionnaire.Results98 hemodialysis (HD) and 102 PD patients were recruited. In univariate analysis, age, sex, level of education, employment status, marital status, traffic time, family support, patient cognition, and receptivity were correlated with treatment with PD. Multivariate analysis showed that patients that were not married ( p = 0.006), that spent more time traveling to the dialysis clinic ( p = 0.006), that were not emergent at the start of dialysis ( p = 0.003), and that had better family support ( p = 0.045), a higher cognition of dialysis ( p = 0.034), and stronger receptivity to dialysis ( p < 0.001) were more likely to receive PD.ConclusionsWe recommend patients follow the standard process to obtain more exhaustive information, consultation, and early referral. In addition, we suggest healthcare providers remind patients to take into account such nonclinical factors as family support and patient receptivity when they choose their dialysis modality.

Incidence and risk factors for HPV-associated cancers in women with end-stage renal disease

2020 ◽  
Vol 68 (5) ◽  
pp. 1002-1010
Author(s):  
Joan Han ◽  
Jennifer L Waller ◽  
Rhonda E Colombo ◽  
Vanessa Spearman ◽  
Lufei Young ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Patients ◽  
Herpes Infection ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage

Human papillomavirus (HPV) causes the majority of cervical, anal/rectal, and oropharyngeal cancers in women. End-stage renal disease (ESRD) is also associated with an increased risk of malignancy, but the incidence of and risk factors for HPV-associated cancers in US dialysis patients are not defined. We queried the US Renal Data System for women with HPV-associated cancers and assessed for incidence of cancer diagnosis and association of risk factors. From 2005 to 2011, a total of 1032 female patients with ESRD had 1040 HPV-associated cancer diagnoses. Patients had a mean age of 65 years, were mostly white (63%), and on hemodialysis (92%). Cervical cancer (54%) was the most common, followed by anal/rectal (34%), and oropharyngeal (12%). The incidence of HPV-associated cancers in patients with ESRD increased yearly, with up to a 16-fold increased incidence compared with the general population. Major risk factors associated with the development of any HPV-associated cancer included smoking (adjusted relative risk=1.89), alcohol use (1.87), HIV (2.21), and herpes infection (2.02). Smoking, HIV, and herpes infection were prominent risk factors for cervical cancer. The incidence of HPV-associated cancers in women with ESRD is rising annually and is overall higher than in women of the general population. Tobacco use is a universal risk factor. For cervical cancer, the presence of HIV and herpes are important comorbidities. Recognizing risk factors associated with these cancers may improve diagnosis and facilitate survival. The role of HPV vaccination in at-risk dialysis patients remains to be defined but warrants further study.

Comparison of Psychological Adjustment to Continuous Ambulatory Peritoneal Dialysis and Home Hemodialysis

1981 ◽  
Vol 2 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Howard J. Burton ◽  
Atara Kaplan De-Nour ◽  
John A. Conley ◽  
George A. Wells ◽  
Lokky Wais
Keyword(s):  
Peritoneal Dialysis ◽  
Psychological Adjustment ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Sexual Satisfaction ◽  
Dialysis Patients ◽  
Home Hemodialysis ◽  
Home Dialysis ◽  
Household Members ◽  
Demographic Background

Two groups of home dialysis patients (40 on CAPD and 37 on home hemo dialysis) matched for length of time on dialysis, and for demographic background were studied and compared. The CAPD patients were significantly more satisfied with the support received from household members and from spouses, more satisfied with the relations with spouses, more understood by them and more understanding of their spouses. Sexual satisfaction declined in both groups. However, sexual satisfaction was slightly higher in the CAPD group and these patients experienced slightly less difficulty in adjusting to the decline; none of these differences were statistically significant.

Peripheral Vascular Disease in Diabetic Peritoneal Dialysis Patients

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 210-214 ◽  
Author(s):  
Heikki H.T. Saha ◽  
Yrjö K.J. Leskinen ◽  
Juha P. Salenius ◽  
Jorma T. Lahtela
Keyword(s):  
Peritoneal Dialysis ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Current Knowledge ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Dialysis Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Review Current

In the present article, we review current knowledge of the epidemiology, diagnosis, and treatment of peripheral vascular disease in patients with end-stage renal disease. The main focus is placed on diabetic patients receiving peritoneal dialysis, but studies on patients receiving hemodialysis are also reviewed, because most reports involve this patient group, and the number of reports on peripheral vascular disease in PD patients alone is limited.

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