TY - JOUR
T1 - Peritoneal Dialysis Use and Practice Patterns
T2 - An International Survey Study
AU - Cho, Yeoungjee
AU - Bello, Aminu K.
AU - Levin, Adeera
AU - Lunney, Meaghan
AU - Osman, Mohamed A.
AU - Ye, Feng
AU - Ashuntantang, Gloria E.
AU - Bellorin-Font, Ezequiel
AU - Gharbi, Mohammed Benghanem
AU - Davison, Sara N.
AU - Ghnaimat, Mohammad
AU - Harden, Paul
AU - Htay, Htay
AU - Jha, Vivekanand
AU - Kalantar-Zadeh, Kamyar
AU - Kerr, Peter G.
AU - Klarenbach, Scott
AU - Kovesdy, Csaba P.
AU - Luyckx, Valerie
AU - Neuen, Brendon
AU - O'Donoghue, Donal
AU - Ossareh, Shahrzad
AU - Perl, Jeffrey
AU - Rashid, Harun Ur
AU - Rondeau, Eric
AU - See, Emily J.
AU - Saad, Syed
AU - Sola, Laura
AU - Tchokhonelidze, Irma
AU - Tesar, Vladimir
AU - Tungsanga, Kriang
AU - Kazancioglu, Rumeyza Turan
AU - Yee-Moon Wang, Angela
AU - Yang, Chih Wei
AU - Zemchenkov, Alexander
AU - Zhao, Ming hui
AU - Jager, Kitty J.
AU - Caskey, Fergus J.
AU - Jindal, Kailash K.
AU - Okpechi, Ikechi G.
AU - Tonelli, Marcello
AU - Harris, David C.
AU - Johnson, David W.
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
KW - access to health care
KW - affordability of health care
KW - end-stage renal disease (ESRD)
KW - Epidemiology
KW - global survey
KW - health care delivery
KW - health care disparities
KW - health policy
KW - home dialysis
KW - international differences
KW - kidney failure
KW - peritoneal dialysis (PD)
KW - renal replacement therapy (RRT)
KW - RRT modality
UR - http://www.scopus.com/inward/record.url?scp=85092075687&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2020.05.032
DO - 10.1053/j.ajkd.2020.05.032
M3 - Article
C2 - 32800844
AN - SCOPUS:85092075687
SN - 0272-6386
VL - 77
SP - 315
EP - 325
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 3
ER -