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Kidney Week

Abstract: PO0951

Increasing the Prevalent Peritoneal Dialysis Patient Population Can Be Challenging

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Dukka, Hari, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
  • Edwards, Emma, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
  • Jain, Anil, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
  • Arora, Dhawal, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
Background

Peritoneal dialysis (PD) can provide better quality of life for patients requiring renal replacement therapy compared to in centre dialysis. It can be challenging to increase prevalent patient population on PD after a certain number is reached. We did a retrospective analysis to assess the turnover of patients on PD over a 8 year period and to understand the reasons for a stagnant prevalent PD population in the renal unit in Royal Derby Hospital.

Methods

Electronic database (Vital data, ICM) were used to document the number of patients starting and stopping PD each year from 2013 to 2020. The reasons for stopping PD and duration of technique survival were noted. If technique failure resulted in conversion to haemodialysis (HD) for more than 3 months, the cause of the failure was also noted. Patients who converted to HD for less than 3 months were excluded from the study.

Results

The number of patients starting ( n=324)and dropping off PD(n=322) was similar for each year between 2013 to 2020 .Modality switch to haemodialysis accounted for 40-60% of patients stopping PD, followed by death (15-30%) and patients receiving renal transplantation (10-35%).Modality switch to haemodialysis was primarily due to infection(60- 80%),poor clearances and ultrafiltration failures(10-30%),social reasons ( 10-15%) . Among patients who switched to HD due to an infection, peritonitis accounted for 75-85% of the cases followed by exit site and tunnel infections (15-25%). Introduction of Kidney quality improvement project in 2018 reduced numbers switching from PD to HD ,with no affect on prevalent patient population due to decrease in incident patient population.

Conclusion

Increasing the prevalent population on PD can be challenging even with a high incident PD population. Having mechanisms which prevent infections, early identification and treatment of infections may help improve prevalent PD population.