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

Abstract

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]

Assistierte Dialyse: Was entwickelt sich in Deutschland und darüber hinaus?

“…Sie stellten fest, dass die asPD häufiger in nichtakademischen Zentren mit einem engagierten Team angeboten wurde. Dies betraf insbesondere westeuropäische und skandinavische Länder, in denen eine höhere Inzidenz und Prävalenz von HD-Patienten berichtet wurde 34 .…”

Assistierte Peritonealdialyse bei älteren und gebrechlichen Patienten

“…In einer europäischen Studie konnten die Autoren einen Zusammenhang zwischen dem Vorhandensein eines PD-Programms und der Inzidenz von Heimdialysepatienten zeigen [3]…”

“…In einer europäischen Studie konnten die Autoren einen Zusammenhang zwischen dem Vorhandensein eines PD-Programms und der Inzidenz von Heimdialysepatienten zeigen 3 . In einer Online-Umfrage wurden Nephrologen und Dialysepflegekräfte (288 Teilnehmer aus verschiedenen Dialysezentren) im Rahmen der Euro PD Future Leadership Initiative befragt.…”

Availability of assisted peritoneal dialysis in Europe: call for increased and equal access

“…Although asPD has been available and widely used in some European countries for many years, it remains unavailable or poorly utilized in many. Indeed, a recent survey of European nephrologists revealed that around 40% had no access to asPD [ 27 ]. With this background, a group of leading nephrologists from a number of western European countries have formed a group to drive increased availability of asPD in Europe and in their own countries.…”