Australian consumer perspectives on dialysis: First national census

Ludlow, Marie; Lauder, Lydia; Mathew, Timothy H.; Hawley, Carmel M.; Fortnum, Debbie

doi:10.1111/j.1440-1797.2012.01651.x

Cited by 23 publications

(31 citation statements)

References 12 publications

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“…More than one third (39%) did not remember having received any information on alternative treatment options than their current one. A similar study in Australia also found that 49% of respondents indicated that they had had no choice in the type of dialysis [49] . Moreover, patients were twice as likely to receive information about HD than about CAPD or APD.…”

Section: Effect Of Patient Preference and Contraindications On Modalimentioning

confidence: 84%

Peritoneal Dialysis in Western Countries

Struijk

2015

Kidney Dis

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and anatomical changes in the peritoneal membrane in time can be monitored by the peritoneal equilibrium test. Peritonitis incidence decreased by introduction of the Y-set and prophylaxis using mupirocin on the exit site. The decrease in the proportion of patients treated with PD in the Western world can be explained by non-medical issues such as inadequate predialysis patient education, physician experience and training, ease of HD initiation, overcapacity of in-center HD, lack of adequate infrastructure for PD treatment, costs and reimbursement issues of the treatment. Facts from East and West: (1) PD is cheaper than HD and provides a better quality of life worldwide, but its prevalence is significantly lower than that of HD in all countries, with the exception of Hong Kong. Allowing reimbursement of PD but not HD has permitted to increase the use of PD over HD in many Asian countries like Hong Kong, Vietnam, Taiwan, Thailand, as well as in New Zealand and Australia over the last years. In the Western world, however, HD is still promoted, and the proportion of patients treated with PD decreases. Japan remains an exception in Asia where PD penetration is very low. Lack of adequate education of practitioners and information of patients might as well be reasons for the low penetration of PD in both the East and West. (2) Patient survival of PD varies between and within countries but is globally similar to HD. (3) Peritonitis remains the main cause of morbidity in PD patients. South Asian countries face specific issues such as high tuberculosis and mycobacterial infections, which are rare in Key WordsPeritoneal dialysis · Solutions · Peritoneal transport · Peritonitis · Costs Abstract Background: Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. Summary: First the major events in the history of the development of PD are described. Then important insights into the physiology of peritoneal transport are discussed and linked to the changes in time observed in biopsies of the peritoneal membrane. Furthermore, the developments in peritoneal access, more biocompatible dialysate solutions, automated PD at home, the establishment of parameters for dialysis adequacy and strategies to prevent infectious complications are mentioned. Finally non-medical issues responsible for the declining penetration in the Western world are analyzed. Key Messages: Only after introduction of the concept of continuous ambulatory PD by Moncrief and Popovich has this treatment evolved in time to a renal replacement therapy. Of all structures present in the peritoneal membrane, the capillary endothelium offers the rate-limiting hindrance for solute and water transport for the diffusive and conve...

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Section: Effect Of Patient Preference and Contraindications On Modalimentioning

confidence: 84%

Peritoneal Dialysis in Western Countries

Struijk

2015

Kidney Dis

View full text Add to dashboard Cite

show abstract

“…The average timing of education delivery was during stage 4–5, with a reported 82% of patients receiving education prior to treatment. PINOT similarly found that the average eGFR of patients receiving education was 13.3 mL/min and that 84% of patients received information prior to treatment, 72% of incident patients were documented to have received PD, and 52% HHD education …”

Section: Discussionmentioning

confidence: 97%

“…Despite all renal units placing a high value on the presence of significant others to support the patient with ESKD, many patients attended education alone. The PINOT study found that only 20% of patients started on home dialysis, but 80% of these had a care‐giver present at education, compared with only 56% of those who started at a centre . Care‐givers and future patients in Italy reported they were concerned about the potential burden of home dialysis .…”

Section: Discussionmentioning

confidence: 99%

“…It would also be beneficial to determine and compare the patient's viewpoint regarding the factors that contributed to whether they and their care‐givers attended pre‐end stage education. As recommended by PINOT, quantitative or qualitative evaluation of education and whether using adult learning principles, patient centred approaches or focusing on life‐style considerations improves learning would also shed more light on what is successful about education delivered …”

Section: Discussionmentioning

confidence: 99%

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