scholarly journals Symptomatic SARS-CoV2 infections in patients treated in France by hemodialysis in an establishment, or at home or by peritoneal dialysis: Data from the REIN and RDPLF registry

2020 ◽  
Vol 3 (4) ◽  
pp. 213-226
Author(s):  
Cécile Couchoud ◽  
Christian Verger
Keyword(s):  
Peritoneal Dialysis ◽  
French Language ◽  
Information Network ◽  
Dialysis Unit ◽  
Asymptomatic Patients ◽  
Risk Of Mortality ◽  
French Speaking ◽  
Delay In Treatment ◽  
Rein Registry ◽  
At Home

In France all patients treated with dialysis are registered in the REIN registry  (Epidemiology and Information Network in Nephrology) ; in addition  the RDPLF (French Language Peritoneal Dialysis Registry) monitors patients treated at home in French-speaking regions and countries. Asymptomatic patients with a positive SARS-CoV2 test were excluded :  the study focused only on patients with symptomatic COVID-19 disease. Data from REIN and RDPLF were used. In total, 3,541 patients were declared symptomatic with COVID-19. The proportion of patients with symptomatic SAR-coV2 infection was 4.9% in patients treated at home by peritoneal dialysis or hemodialysis and 8.0% in those treated in a dialysis unit. After adjustment for age and comorbidities, being treated at home was associated with a higher risk of mortality. In conclusion, home treatments could represent a solution for preventing the risk of contamination during the circulation of the virus. On the other hand, the risk of mortality in symptomatic patients at home could be linked to a delay in treatment: rigorous remote organization must be implemented so as not to delay the treatment of patients in the event of infection.

scholarly journals Synthetic 2018 data report of the French Language Peritoneal Dialysis and Home Hemodialysis Registry (RDPLF)

2019 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Christian Verger ◽  
Emmanuel Fabre ◽  
Ghislaine Veniez ◽  
Marie Christine Padernoz
Keyword(s):  
Peritoneal Dialysis ◽  
French Language ◽  
Home Hemodialysis ◽  
Dialysate Flow ◽  
Dialysate Flow Rate ◽  
Core Module ◽  
French Speaking ◽  
Patient Profiles ◽  
Transitional Mode

The RDPLF was created in 1986 and collects the main data of peritoneal dialysis of French patients and of various French-speaking countries. The database is structured in several modules: a compulsory core module including a follow-up of comorbidities, assistance, infections, survival, transplantation, and optional modules following more specific aspects: nursing, catheter, anemia, nutrition, heart failure. In addition, since 2012 patients treated at home in hemodialysis are also followed. This article presents a summary of the main characteristics of patients in the RDPLF in 2018. It highlights important differences in practices and patient profiles between francophone countries. Daily low dialysate flow rate hemodialysis is predominant in the new centers and sometimes begins to appear as a transitional mode that allows home maintenance for patients who cannot continue on peritoneal dialysis.

The Organization and Implementation of a Peritoneal Dialysis Program

1980 ◽  
Vol 1 (7) ◽  
pp. 134-136 ◽  
Author(s):  
Sheila Clayton
Keyword(s):  
Peritoneal Dialysis ◽  
Home Visits ◽  
Hospitalized Patients ◽  
Chronic Peritoneal Dialysis ◽  
Close Collaboration ◽  
Careful Planning ◽  
Dialysis Unit ◽  
Number Of Patients ◽  
Auxiliary Personnel ◽  
At Home

The organization of a chronic peritoneal dialysis program requires careful planning and close collaboration between nurses and doctors. In-center peritoneal dialysis should be used primarily for back-up dialysis of home PD patients with complications, and for those who cannot be dialyzed at home. If a unit has a large number of patients at home, it needs a larger number of in-center nurses to care for the increased numbers of hospitalized patients. The home peritoneal dialysis unit should be located near the center unit. The home nurses should be responsible for training, home visits, for clinics and for monthly tubing changes. The unit also needs a number of auxiliary personnel to complement the work of the training nurses.

Effect of social deprivation on peritoneal dialysis uptake: A mediation analysis with the data of the REIN registry

2021 ◽  
pp. 089686082110232
Author(s):  
Mathilde Beaumier ◽  
Eve Calvar ◽  
Ludivine Launay ◽  
Clémence Béchade ◽  
Antoine Lanot ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Haemoglobin Level ◽  
Mediation Analysis ◽  
Social Deprivation ◽  
Male Gender ◽  
Dialysis Initiation ◽  
Information Network ◽  
Counterfactual Approach ◽  
Rein Registry ◽  
Active Cancer

Background: Social deprivation could act as a barrier to peritoneal dialysis (PD). The objective of this study was to assess the association between social deprivation estimated by the European deprivation index (EDI) and PD uptake and to explore the potential mediators of this association. Methods: From the Renal Epidemiology and Information Network registry, patients who started dialysis in 2017 were included. The EDI was calculated based on the patient’s address. The event of interest was the proportion of PD 3 months after dialysis initiation. A mediation analysis with a counterfactual approach was carried out to evaluate the direct and indirect effect of the EDI on the proportion of PD. Results: Among the 9588 patients included, 1116 patients were on PD; 2894 (30.2%) patients belonged to the most deprived quintile (Q5). PD was associated with age >70 years (odds ratio (OR) 0.79 [95% confidence interval (CI): 0.69–0.91]), male gender (0.85 [95% CI: 0.74–0.97]), cardiovascular disease (OR 0.86 [95% CI: 0.86–1.00]), chronic heart failure (OR 1.34 [95% CI: 1.13–1.58]), active cancer (OR 0.67 [95% CI: 0.53–0.85]) and obesity (OR 0.75 [95% CI: 0.63–0.89]). In the mediation analysis, Q5 had a direct effect on PD proportion OR 0.84 [95% CI: 0.73–0.96]. The effect of Q5 on the proportion of PD was mediated by haemoglobin level at dialysis initiation (OR 0.96 [95% CI: 0.94–0.98]) and emergency start (OR 0.98 [95% CI: 0.96–0.99]). Conclusion: Social deprivation, estimated by the EDI, was associated with a lower PD uptake. The effect of social deprivation was mediated by haemoglobin level, a proxy of predialysis care and emergency start.

scholarly journals Home dialysis in french speaking countries in 2020 (RDPLF database)

2021 ◽  
Vol 4 (1) ◽  
pp. 55-70
Author(s):  
Christian Verger ◽  
Ghislaine Veniez ◽  
Marie-Christine Padernoz ◽  
Emmanuel Fabre
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Symptoms ◽  
Low Flow ◽  
Central Catheter ◽  
Dialysis Treatment ◽  
Home Dialysis ◽  
Daily Hemodialysis ◽  
French Speaking ◽  
Patient Profiles ◽  
At Home

The RDPLF collects the main peritoneal dialysis data from centers in French-speaking countires and, since 2012, home hemodialysis (HHD) data. This article presents a summary of the main results in the RDPLF in 2020. It highlights important differences in the practices and patient profiles between French-speaking countries. Mortality in patients with clinical symptoms of COVID-19 varied from 15 to 63% depending on the country. A slight drop in the incidence rate for peritoneal dialysis in 2020 was observed when the Covid-19 pandemic should have favored a dialysis treatment at home. In patients with HHD, daily hemodialysis five days a week, at a low flow rate of dialysate, is predominant in the new centers and sometimes begins to appear as a mode of transition which allows to maintain at home patients who cannot anymore be treated by PD. In HHD, the use of a central catheter is frequent in Belgium while this is exceptional in France. Likewise, in France, puncture of an arteriovenous fistula remains classic, while in Belgium the Buttonhole technique is widely preferred. We did not observe COVID-19 mortality in HHD in 2020 but only 47% of HDD patients are included in the RDPLF while 98% of PD patients are included.

scholarly journals Home dialysis and Covid-19 in french speaking countries (RDPLF data-base)

2021 ◽  
Vol 4 (3) ◽  
pp. 227-237
Author(s):  
Christian Verger ◽  
Emmanuel Fabre ◽  
Pierre-Yves Durand ◽  
Jacques Chanliau ◽  
Isabelle Vernier ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Data Base ◽  
Dialysis Patients ◽  
Home Hemodialysis ◽  
Home Dialysis ◽  
Number Of Patients ◽  
French Speaking ◽  
Surgical Teams ◽  
At Home

Aims of the study: to assess the frequency of symptomatic Covid-19 in home dialysis patients and its influence on the number of patients treated at home in dialysis units of centers included in the French-speaking peritoneal and home hemodialysis Registry (RDPLF). Focus is placed on patients treated by peritoneal dialysis (PD) in mainland France. Results: in home hemodialysis (HHD)the incidence is 6% in Belgium and 4.8% in mainland France. On peritoneal dialysis it is 10.6% in Belgium, 6.7% in mainland France, 10.8% in Morocco and 11.5% in Tunisia. Lethality is less than 5% in HHD and between 8.4% and 42.7% in PD depending on age and associated comorbidities. In France, the percentage of patients who have had symptomatic Covid-19 is lower on home dialysis, all methods combined. Nevertheless, among the home methods, the higher frequencies and severities are observed in mainland France in home assisted PD: these are the oldest and most co-morbid patients. Transfers from PD to in center hemodialysis have increased during Covid-19 pandemic while the number of transplants has decreased. Conclusion: if the drop in the number of transplants can be explained by a reduced availability of operating theaters and surgical teams during a pandemic period, it is paradoxical that the prescription of home dialysis, which should be supposed to limit the risk of contagion, has decreased. More investigation should be performed to understand this paradox.  

Abnormal iron status is associated with an increased risk of mortality in patients on peritoneal dialysis

2021 ◽  
Vol 31 (4) ◽  
pp. 1148-1155
Author(s):  
Dan Luo ◽  
Zhong Zhong ◽  
Yagui Qiu ◽  
Yating Wang ◽  
Hongyu Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Status ◽  
Risk Of Mortality ◽  
Increased Risk

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

2002 ◽  
Vol 22 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Danuta Antczak-Jȩdrzejczak ◽  
Magdalena Leander
Keyword(s):  
Peritoneal Dialysis ◽  
Dwell Time ◽  
Control Period ◽  
University Hospital ◽  
Control Group ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Dialysis Solution ◽  
Glucose Ratio ◽  
Peritoneal Permeability

Background Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. Objectives An evaluation of dialysate-to-plasma ratio (D/P) of urea, D/P creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Single-center prospective study with PG-DS; retrospective selection of the control group. Setting Peritoneal dialysis unit in a university hospital. Patients Fourteen patients (11 males; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPD duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. Methods Standard PET was carried out at 1.6 ± 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 ± 0.6 months’ use of PG-DS (study period II, n = 14), after 4.4 ± 0.8 months’ use of PG-DS (study period III, n = 11), after 8.8 ± 2.2 months’ use of PG-DS (study period IV, n = 9), and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I – V). Results In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II – IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but KBD glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. Conclusion Changes in peritoneal permeability are observed in CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

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