International Variations in Peritoneal Dialysis Utilization and Implications for Practice

In many countries, the use of peritoneal dialysis (PD) remains low despite arguments that support its greater use, including dialysis treatment away from hospital settings, avoidance of central venous catheters, and potential health economic advantages. Training patients to manage aspects of their o...

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Bibliographic Details
Published in:American journal of kidney diseases Vol. 74; no. 1; p. 101
Main Authors: Briggs, Victoria, Davies, Simon, Wilkie, Martin
Format: Journal Article
Language:English
Published: United States 01.07.2019
Subjects:
Humans
Internationality
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - therapy
Peritoneal Dialysis - adverse effects
Peritoneal Dialysis - economics
Peritoneal Dialysis - methods
Peritoneal Dialysis - psychology
Procedures and Techniques Utilization - statistics & numerical data
Quality of Life
modality selection
Index Words: Peritoneal dialysis (PD)
PD First
health care policy
international comparisons
health care costs
catheter placement
infectious complications
dialysis modality
end-stage renal disease (ESRD)
urgent-start PD
kidney replacement therapy (KRT)
health care reimbursement
technique failure
ISSN:1523-6838, 1523-6838
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Summary:In many countries, the use of peritoneal dialysis (PD) remains low despite arguments that support its greater use, including dialysis treatment away from hospital settings, avoidance of central venous catheters, and potential health economic advantages. Training patients to manage aspects of their own care has the potential to enhance health literacy and increase patient involvement, independence, quality of life, and cost-effectiveness of care. Complex reasons underlie the variable use of PD across the world, acting at the level of the patient, the health care team that is responsible for them, and the health care system that they find themselves in. Important among these is the availability of competitively priced dialysis fluid. A number of key interventions can affect the uptake of PD. These include high-quality patient education around dialysis modality choice, timely and successful catheter placement, satisfactory patient training, and continued support that is tailored for specific needs, for example, when people present late requiring dialysis. Several health system changes have been shown to increase PD use, such as targeted funding, PD First initiatives, or physician-inserted PD catheters. This review explores the factors that explain the considerable international variation in the use of PD and presents interventions that can potentially affect them.
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ISSN:1523-6838
1523-6838
DOI:10.1053/j.ajkd.2018.12.033