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Does catheter insertion by nephrologists improve peritoneal dialysis utilization? A multicenter analysis.
Arif Asif1, Timothy A Pflederer, Cristovao F Vieira
1Department of Medicine, Division of Nephrology, University of Miami School of Medicine, Miami, Florida 33136, USA. Aasif@med.miami.edu
Seminars in Dialysis
|March 18, 2005
Summary
Nephrologist-performed peritoneal dialysis (PD) catheter insertion programs significantly increased PD utilization in the US. This approach positively impacts PD patient numbers, enhancing this renal replacement therapy option.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Medical Procedures
Background:
- Peritoneal dialysis (PD) is underutilized in the US compared to hemodialysis (HD).
- Timely PD catheter insertion is crucial for patient access to PD therapy.
- Traditional surgical approaches may limit PD program growth.
Purpose of the Study:
- To evaluate the impact of nephrologist-led PD catheter insertion programs on PD patient population growth.
- To compare PD utilization rates before and after the implementation of nephrologist-performed catheter insertions.
Main Methods:
- A multicenter analysis comparing PD patient numbers before and after nephrologist-initiated PD catheter insertion programs.
- Nephrologists utilized peritoneoscopic technique under local anesthesia for catheter placement.
- Data collected from three centers examining PD patient prevalence relative to the end-stage renal disease (ESRD) population.
Main Results:
- Center 1: PD patients increased from 38-45 (16% of ESRD) to 101 (32%) after program initiation.
- Center 2: PD patients increased from 70-78 (17% of ESRD) to 125 (22%) after program initiation.
- Center 3: PD patients increased from 20-30 (18% of ESRD) to 97 (27%) after program initiation, declining to 25 (6%) after suspension.
Conclusions:
- Nephrologist-performed PD catheter insertion positively impacts PD utilization.
- Establishing nephrologist-led PD catheter insertion programs can significantly increase the number of patients on PD.
- This minimally invasive approach enhances access to PD as a renal replacement therapy.