Peritoneal Dialysis Use and Practice Patterns: An International Survey Study
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
32800844
DOI
10.1053/j.ajkd.2020.05.032
PII: S0272-6386(20)30891-X
Knihovny.cz E-resources
- Keywords
- Epidemiology, RRT modality, access to health care, affordability of health care, end-stage renal disease (ESRD), global survey, health care delivery, health care disparities, health policy, home dialysis, international differences, kidney failure, peritoneal dialysis (PD), renal replacement therapy (RRT),
- MeSH
- Kidney Failure, Chronic therapy MeSH
- Health Services Accessibility * MeSH
- Patient Reported Outcome Measures MeSH
- Outcome Assessment, Health Care MeSH
- Internationality * MeSH
- Quality of Health Care MeSH
- Physicians MeSH
- Practice Patterns, Physicians' * MeSH
- Humans MeSH
- Costs and Cost Analysis MeSH
- Nephrology MeSH
- Nephrologists MeSH
- Peritoneal Dialysis * MeSH
- Cost Sharing MeSH
- Delivery of Health Care MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Developing Countries MeSH
- Administrative Personnel MeSH
- Health Expenditures MeSH
- Developed Countries MeSH
- Health Policy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
RATIONALE & OBJECTIVE: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. STUDY DESIGN: A cross-sectional survey. SETTING & PARTICIPANTS: Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018. OUTCOMES: PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. ANALYTICAL APPROACH: Descriptive statistics. RESULTS: Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes. LIMITATIONS: Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data. CONCLUSIONS: Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia.
Department of Community Health Sciences University of Calgary Calgary Alberta Canada
Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong
Department of Nephrology General University Hospital Charles University Prague Czech Republic
Department of Nephrology Kidney Foundation Hospital and Research Institute Dhaka Bangladesh
Department of Renal Medicine Singapore General Hospital Singapore
Dialysis Unit CASMU IAMPP Montevideo Uruguay
Division of Nephology and Hypertension Department of Medicine Saint Louis University Saint Louis MO
Division of Nephrology and Hypertension University of California Irvine Medical Center Orange CA
Division of Nephrology and Hypertension University of Cape Town Cape Town South Africa
Division of Nephrology Bezmialem Vakif University Istanbul Turkey
George Institute for Global Health UNSW New Delhi India
Nephrology Development Clinical Center Tbilisi State Medical University Tbilisi Georgia
Nephrology Division Department of Internal Medicine The Specialty Hospital Amman Jordan
Oxford Kidney Unit Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
References provided by Crossref.org
