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Kidney Week

Abstract: TH-PO876

Barriers to Peritoneal Dialysis in Kenya

Session Information

  • Peritoneal Dialysis - I
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Author

  • Sokwala, Ahmed Parwizali, Aga Khan University Hospital, Nairobi, Kenya
Background

Peritoneal dialysis ( PD ) is not commonly practiced in Kenya. Kenya has approximately 4000 patients on hemodialysis ( HD ) with less than 20 patients on PD. The perception and attitude of both the patient and the doctor on the modality of chronic renal replacement therapy determines what type of dialysis the patient will be started on. Increase in PD in developing countries with poor infrastructure for HD, will increase the number of patients who can access renal replacement therapy for both acute kidney injury and end stage renal disease.

Methods


A questionnaire was formulated and mailed to the nephrologists to determine their attitude towards PD and to bring out the reasons why they are reluctant to start peritoneal dialysis.A total of 22 questions were formulated and the questionaires mailed to the 25 nephrologists in the region. Questions were about the nephrologists' opinions on reasons that limited patients and doctors selection of peritoneal dialsis as initial therapy. After analyzing the reasons, interventions can be put into place to improve the numbers of patients on peritoneal dialysis.

Results

Twenty three out of twenty five ( 93% ) nephrologists responded to the questions. Only 38% of the nephrologists took care of patients on peritoneal dialysis and out of those 55% of the nephrologists had less than 2 patients on PD. Despite that 70% of the nephrologist thought that more than 20% of end stage renal disease patients should be on PD. Most of the doctors said they had adequate training and exposure to peritoneal dialysis in their training. Lack of nursing expertise was one of the main reasons stated by the nephrologist as being the main chalenge of starting peritoneal dialysis. Lower physcian reimbursement for peritoneal dialysis vis a vis haemodialysis was another point brought out, the Government had started paying for hemodialysis rather than peritoneal dialsysis The other major hinderance was insertion and care of the peritoneal dialysis catheter. Most nephrologists thought patients do well on peritoneal dialysis with no mortality difference between PD and HD .

Conclusion

There is positive attitude about PD amongst the nephrologist. Training more nurses on peritoneal dialysis and training doctors on bedside insertion of peritoneal dialysis catheres will probably increase the uptake of peritoneal dialysis in our country. Nephrologists should be equally reimbursed for PD as for HD or even better.