Underutilization of Peritoneal Dialysis

Heaf, James

doi:10.1001/jama.291.6.740

Cited by 51 publications

(37 citation statements)

References 25 publications

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“…This decline in PD use has been noted by others and may be explained by a few factors. 3,[15][16][17]23,24 Several economic influences, including health care financing and delivery, physician reimbursement, and resource availability, have been suggested to affect trends in use. 3 For example, countries with private dialysis providers generally use PD for a smaller proportion of dialysis patients than countries in which public providers dominate.…”

Section: Resultsmentioning

confidence: 99%

Global Trends in Rates of Peritoneal Dialysis

Jain

Blake²,

Cordy³

et al. 2012

Journal of the American Society of Nephrology

461

403

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Although there is a perception that the use of peritoneal dialysis is declining worldwide, compilations of global data are unavailable to test this hypothesis. We assessed longitudinal trends in the use of peritoneal dialysis from 1997 to 2008 in 130 countries. The preferred data sources were renal registries, followed by nephrology societies, health ministries, academic centers, national experts, and industry affiliates. In 2008, there were approximately 196,000 peritoneal dialysis patients worldwide, representing 11% of the dialysis population. In total, 59% were treated in developing countries and 41% in developed countries. Over 12 years, the number of peritoneal dialysis patients increased in developing countries by 24.9 patients per million population and in developed countries by 21.8 per million population. The proportion of all dialysis patients treated with peritoneal dialysis did not change in developing countries but significantly declined in developed countries by 5.3%. The use of automated peritoneal dialysis increased by 14.5% in developing countries and by 30.3% in developed countries. In summary, the number of patients treated with peritoneal dialysis rose worldwide from 1997 to 2008, with a 2.5-fold increase in the prevalence of peritoneal dialysis patients in developing countries. The proportion of all dialysis patients treated with this modality continues to decline in developed countries. Chronic dialysis is a life-sustaining treatment for patients with ESRD. Access to dialysis remains limited in several regions of the world due to a lack of financial and clinical resources. [1][2][3][4][5][6][7][8][9] As countries look to develop dialysis programs to manage the growing burden of ESRD, it is important to place patterns of peritoneal dialysis (PD) use in the global context. This information is particularly helpful to individuals in member nations responsible for health care delivery to evaluate their PD programs through comparisons with countries of similar socioeconomic structure.A comprehensive global assessment of PD use to date has been lacking. One study suggested that 11% of chronic dialysis patients around the world are treated with PD. 10 Several renal registries report PD use at a national and regional level, 11-14 but not on a global scale. There is a perception that PD use is declining worldwide. However, studies that showed declining PD use in the developed world are limited by the number of countries considered and the length of time examined. 3,[15][16][17] No study has examined the global use of different PD modalities over a significant period of time, including continuous ambulatory PD (CAPD) and automated PD (APD). For these reasons, we assessed PD use worldwide by compiling data from multiple sources over a 12-year period. We examined the trends in PD use across developing and developed nations, focusing on crude numbers, prevalence per million population, and the proportion of dialysis patients who received PD. We hypothesized an increasing PD prevalence in the dev...

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Section: Resultsmentioning

confidence: 99%

Global Trends in Rates of Peritoneal Dialysis

Jain

Blake²,

Cordy³

et al. 2012

Journal of the American Society of Nephrology

461

403

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“…Therefore, the patient’s preference should be taken into account as the primary factor, since patient satisfaction, compliance with therapy and quality of life are better if the patient has been given the opportunity to make his/her own informed choice. Actually, in most European Countries and also at EU level, it is compulsory by law to inform patients of all treatment modalities [11,12]. …”

Section: Initial Dialysis Modality Selectionmentioning

confidence: 99%

Educating end-stage renal disease patients on dialysis modality selection

Covic

Bammens

Lobbedez

et al. 2010

Clinical Kidney Journal

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“…Recent data from observational studies and the US Renal Data System, however, suggest that patients with chronic kidney disease may not be presented with adequate information on treatment options or given sufficient time in which to discuss management alternatives with their families or carers. [5][6][7][8] Low rates of kidney transplantation in patients on low incomes and those from minority ethnic groups also suggest that patient and family preferences are not being taken into account. [9][10][11] Although large numbers of patients with chronic kidney disease exist worldwide, data on the factors that influence preferences for treatment from a patient or carer perspective are limited.…”

Section: Introductionmentioning

confidence: 99%

The views of patients and carers in treatment decision making for chronic kidney disease: systematic review and thematic synthesis of qualitative studies

Morton

Tong

Howard

et al. 2010

BMJ

445

478

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Objective To synthesise the views of patients and carers in decision making regarding treatment for chronic kidney disease, and to determine which factors influence those decisions.Design Systematic review of qualitative studies of decision making and choice for dialysis, transplantation, or palliative care, and thematic synthesis of qualitative studies.Data sources Medline, PsycINFO, CINAHL, Embase, social work abstracts, and digital theses (database inception to week 3 October 2008) to identify literature using qualitative methods (focus groups, interviews, or case studies).Review methods Thematic synthesis involved line by line coding of the findings of the primary studies and development of descriptive and analytical themes.Results 18 studies that reported the experiences of 375 patients and 87 carers were included. 14 studies focused on preferences for dialysis modality, three on transplantation, and one on palliative management. Four major themes were identified as being central to treatment choices: confronting mortality (choosing life or death, being a burden, living in limbo), lack of choice (medical decision, lack of information, constraints on resources), gaining knowledge of options (peer influence, timing of information), and weighing alternatives (maintaining lifestyle, family influences, maintaining the status quo).Conclusions The experiences of other patients greatly influenced the decision making of patients and carers. The problematic timing of information about treatment options and synchronous creation of vascular access seemed to predetermine haemodialysis and inhibit choice of other treatments, including palliative care. A preference to maintain the status quo may explain why patients often remain on their initial therapy.

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Underutilization of Peritoneal Dialysis

Cited by 51 publications

References 25 publications

Global Trends in Rates of Peritoneal Dialysis

Global Trends in Rates of Peritoneal Dialysis

Educating end-stage renal disease patients on dialysis modality selection

The views of patients and carers in treatment decision making for chronic kidney disease: systematic review and thematic synthesis of qualitative studies

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