Peritoneal dialysis in the Sudan.

Area of Science:

• Nephrology
• Public Health
• Renal Replacement Therapy

Background:

• End-stage renal disease poses a significant socioeconomic burden in Sudan.
• Continuous Ambulatory Peritoneal Dialysis (CAPD) was introduced as a free national service.
• This study evaluates the initial 20 months of the national CAPD program's organization and outcomes.

Purpose of the Study:

• To assess the feasibility and outcomes of a national CAPD program in Sudan.
• To analyze patient and technique survival, peritonitis rates, and dialysis adequacy.
• To identify areas for improvement in the national CAPD service.

Main Methods:

• A national CAPD program was launched sequentially in 7 centers in Khartoum.
• Data from 111 patients undergoing CAPD between June 2005 and January 2007 were analyzed.
• Key performance indicators including peritonitis rates and adequacy parameters were collected and evaluated.

Main Results:

• 111 patients were enrolled; 18% shifted to hemodialysis, 5% received transplants, and 14% died from non-PD-related causes.
• The peritonitis rate was 1 episode every 14 months (0.87 episodes/year), higher in younger patients (mean age 30.53 years).
• Dialysis adequacy indicators (Kt/V, creatinine clearance, protein catabolic rate) were satisfactory and within recommended ranges.

Conclusions:

• The national CAPD program in Sudan is a promising initiative with multifaceted success.
• While dialysis adequacy is acceptable, peritonitis rates exceed recommendations, highlighting areas for improvement.
• Ongoing challenges with medication and laboratory costs are being addressed with governmental and public support.