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Related Experiment Videos

Peritoneal dialysis underutilization: the impact of an interventional nephrology peritoneal dialysis access program.

Arif Asif1, Patricia Byers, Florin Gadalean

  • 1Division of Nephrology, Department of Medicine, University of Miami School of Medicine, Miami, Florida 33136, USA.

Seminars in Dialysis
|May 20, 2003
PubMed
Summary

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Nephrologists can improve peritoneal dialysis (PD) access. A dedicated PD access program increased PD use by nearly doubling the patient population, enhancing patient choice and treatment initiation.

Area of Science:

  • Nephrology
  • Interventional Nephrology

Background:

  • Peritoneal dialysis (PD) is an underutilized renal replacement therapy in the US.
  • Current PD access placement often involves general surgeons, causing treatment delays and loss of nephrologist control.

Purpose of the Study:

  • To assess the impact of an interventional nephrology (IN) PD access placement program integrated with a chronic kidney disease (CKD) education program.

Main Methods:

  • Nephrologists performed PD catheter insertions, removals, and repositioning procedures peritoneoscopically under local anesthesia in an IN lab.
  • A Fogarty catheter was used for migrated catheter repositioning.

Main Results:

  • 71 procedures were performed on 46 patients, including 51 PD catheter insertions.

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  • 37 of 46 patients maintained a functional PD catheter with an average follow-up of 8.6 months.
  • The PD patient population increased from 43 to 80 within 18 months.

    • Conclusions:

    • A dedicated PD access placement program, combined with CKD education, significantly increases PD utilization and patient choice.
    • Nephrologist-led PD access placement can streamline treatment initiation and improve patient outcomes.