Implementing Assisted Peritoneal Dialysis in Renal Care: a Chinese-German Perspective

Pommer, Wolfgang; Su, Xin; Zhang, Mengbi; Liu, Fanna; Li, Yin

doi:10.1159/000494679

Cited by 10 publications

(12 citation statements)

References 30 publications

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“…36,[40][41][42][43] A Chinese-German study stated that 'a timely pre-dialysis education, implementation of a structured model for care, education and training of helping staff, and constantly monitoring of quality parameters is necessary' to promote assisted PD. 44 So, to treat more patients with assisted PD in Europe, it seems appropriate to invest in a dedicated team of healthcare professionals who provide adequate education and support patients on assisted PD.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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]

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…The observed effect of this is the older average age of patients on PD in countries where aPD is offered. For example, in Germany patients with ESRD started on PD are on average 60 years of age (62.5 male/57.0 female), compared to HD where they are 72 years of age (71.0 male/73.0 female) [15]. Meanwhile in France, where there exists a well-funded aPD program, the median age of patients on PD is 71 years [14].…”

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

Health Outcomes and Cost Considerations of Assisted Peritoneal Dialysis: A Narrative Review

Maierean

Oliver

2021

Blood Purif

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Background: Peritoneal dialysis (PD) is underutilized in many parts of the world despite pro-PD health policies. The physical and cognitive demands of PD means that over half of eligible patients require some form of assistance. As such, many countries now offer assisted PD (aPD) programs to help patients start or stay on PD as opposed to in-center hemodialysis (HD). In order to evaluate the potential scope of aPD, it is important to review the outcomes and cost considerations of aPD. Summary: We reviewed available data from different countries and regions for health outcomes between aPD and in-center HD, with a focus on quality of life (QoL), mortality, hospitalization, and technique survival. We also evaluated studies discussing the overall costs of delivering aPD, including training, operating costs, and indirect costs and compared these to in-center HD costs for the same regions. Key Messages: aPD patients are older and more frail than either self-care PD patients and many in-center HD patients. We found no evidence for any difference in QoL, mortality, or hospitalization between aPD and in-center HD after adjustment for these differences. There is some evidence for an association between nurse assistance and improved technique survival as compared to family assistance or self-care PD. Despite increased cost of providing assistance in PD, it is still significantly less expensive than in-center HD in Western Europe and Canada.

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“…However, in countries where an asPD program exists, patients on PD are older, compared with those without asPD programs. For example in France, where a well-established asPD program has existed for years, median age at PD start is 71 years [ 4 ], compared with an average of 60 years in German [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Assisted peritoneal dialysis: strategies and outcomes

et al. 2022

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Assisted peritoneal dialysis (asPD) is a modality intended for not self-sufficient patients, mainly elderly, who are not able to perform peritoneal dialysis (PD) alone and require some help to manage the treatment. In the last decades, many countries developed strategies of asPD to face with aging of dialysis population and give an answer to the increasing demand of health service for elderly. Model of asPD varies according to the type of assistants employed and intensity of assistance provided. Both health care and non-health care assistants have been used with good clinical results. A mixed model of help, using different professional figures for short time or for longer according to patients’ need, has been proved successful and cost-effective. Outcomes of asPD are reported in different ways, and the comparative effect of asPD is unclear. Quality of life has rarely been evaluated; however, patients seem to be satisfied with the assistance provided, since it allows them to both retain independence and to be relieved from the burden of self-care. Assisted PD should not be intended as a PD-favoring strategy, but as a model that allows home dialysis also in patients who would not be eligible for PD because of social, cognitive or physical barriers.

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Implementing Assisted Peritoneal Dialysis in Renal Care: a Chinese-German Perspective

Cited by 10 publications

References 30 publications

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

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

Health Outcomes and Cost Considerations of Assisted Peritoneal Dialysis: A Narrative Review

Assisted peritoneal dialysis: strategies and outcomes

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