ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: FR-OR109

International PD Training Practices and the Risk of Peritonitis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis


  • Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
  • Fuller, Douglas S., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Boudville, Neil, University of Western Australia, Nedlands, Western Australia, Australia
  • Ito, Yasuhiko, Aichi Medical University, Nagakute, Aichi, Japan
  • Kanjanabuch, Talerngsak, Chulalongkorn University, Bangkok, Thailand
  • Piraino, Beth M., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Szeto, Cheuk-Chun, The Chinese University of Hong Kong, Shatin, Hong kong, China
  • Teitelbaum, Isaac, University of Colorado, Aurora, Colorado, United States
  • Woodrow, Graham, St James University Hospital, Leeds, United Kingdom
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia

Patient training for peritoneal dialysis (PD) is vital in reducing the risk of complications, including PD-related peritonitis. We describe variation in training practices across countries and assess their impact on peritonitis risk.


Using Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS; 2014-2017) data from Australia and New Zealand (A/NZ), Canada (CA), Japan (JP), Thailand (TH), the UK, and the US (non-large dialysis organization facilities), we report variation in facility-reported PD training practices and estimate associations with peritonitis using proportional rates models adjusted for patient and facility factors.


183 out of 204 facilities with peritonitis data available returned a PDOPPS Unit Practices Survey (US, n=83; other, n=14-26). Nearly all facilities reported using unit-affiliated training nurses only (UK, 72%; other, >95%), a standard training curriculum (UK, 65%; JP, 79%; other, >90%), individualized training (TH, 41%; other, >88%) and a single nurse per patient (JP, 28%; A/NZ, 71%; other, >89%). All facilities required successful technique demonstration; 50% (US, 88%; other, 4-36%) required a written test, and 55% (CA, JP, UK, 24-40%; A/NZ, TH, US: 57-70%) required an oral test. Peritonitis rate was associated with the timing of training relative to catheter insertion (HR=1.12 [95% CI=0.87, 1.44], HR=1.34 [1.04, 1.72], and HR=1.47 [1.11, 1.96] for 1, 2, or 3 weeks after catheter insertion, respectively, vs. prior to insertion; p<0.01 for trend) and longer duration of training (HR=1.04 [0.86, 1.24] and HR=0.84 [0.69, 1.02] for 4-5 and ≥6 days, respectively, vs. 2-3 days; p=0.06 for trend).


Variation in PD training practices was seen across PDOPPS countries. Given the patient-centered nature of PD, earlier and longer training periods may reduce peritonitis risk.


  • NIDDK Support