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2015 ; 2015
(ä): 431092
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Overcoming the Underutilisation of Peritoneal Dialysis
#MMPMID26640787
Pajek J
Biomed Res Int
2015[]; 2015
(ä): 431092
PMID26640787
show ga
Peritoneal dialysis is troubled with declining utilisation as a form of renal
replacement therapy in developed countries. We review key aspects of therapy
evidenced to have a potential to increase its utilisation. The best evidence to
repopulate PD programmes is provided for the positive impact of timely referral
and systematic and motivational predialysis education: average odds ratio for
instituting peritoneal dialysis versus haemodialysis was 2.6 across several
retrospective studies on the impact of predialysis education. Utilisation of PD
for unplanned acute dialysis starts facilitated by implantation of peritoneal
catheters by interventional nephrologists may diminish the vast predominance of
haemodialysis done by central venous catheters for unplanned dialysis start.
Assisted peritoneal dialysis can improve accessibility of home based dialysis to
elderly, frail, and dependant patients, whose quality of life on replacement
therapy may benefit most from dialysis performed at home. Peritoneal dialysis
providers should perform close monitoring, preventing measures, and timely
prophylactic therapy in patients judged to be prone to EPS development. Each
peritoneal dialysis programme should regularly monitor, report, and act on key
quality indicators to manifest its ability of constant quality improvement and
elevate the confidence of interested patients and financing bodies in the
programme.