[Results of applying the Scientific Technical Quality Programme and Constant Quality Improvement for peritoneal...

In last time it was tried to homogenize the clinical activity and to make the decisions easier. In the field of Nephrology, the Spanish Society of Nephrology has developed different guidelines that have managed an improvement in patient s monitoring. That is the reason why the Quality Working Group in Nephrology was created, whose basic working field was haemodialysis, although its collaboration with an expert group in peritoneal dialysis (PD) has allowed the developement of a Scientific Technical Quality Programme and Constant Quality Improvement in PD.

We checked the clinical histories of all the patients in PD in the course of 2008 in the Peritoneal Dialysis Unit at our institution and we evaluated all the quality indicators that were described in the Scientific Technical Quality Programme and of Constant Quality Improvement in PD.

During 2008 a total of 41 patients were treated in the Peritoneal Dialysis Unit at our institution, 43.9% women. Incidence was 14 (51.8%) and 21.4% were diabetics. No patients cames from transplant unit and 2 came from haemodilalysis unit (7.1%). Mean age in incident population was 60 +/- 13 years and in prevalent population was 53.9 +/- 14.4 years. Mean follow-up in PD was 25.9 +/- 19.9 months. Modified Charlson comorbility index average in incident patients was 6 and in prevalent patients was 5. 70.7% were included in transplant programme and 3 were transplanted in the year s course (10.3%). There were 19 hospital admissions (rate: 0.46 admission per patient/year in risk) with a mean stay of 7.3 days (rate: 3.4 days per patient/year in risk). During 2008 6 patients leaved PD (2 transfers to haemodialysis, 3 transplants and 1 death). 16 infective peritonitis (overall rate: 1 episode every 24 months) and 23 exit side infections were reported (rate: 1 episode every 18 months). Mean Kt/V was 2,4 +/- 0.06 (92.7% of patients achieved the stablished standards). All non-anuric patients had measured residual renal function and only 1 patient did not achieve the goal of fluid output > 1000 ml/day. No patient used 3.86-4.25% bags. Stablished standards were achieve by analitic indicators with regard to epoetin resistence index, LDL- cholesterol, phosphate, calcium-phosphate product and PTH.

The application of the Scientific Technical Quality Programme and of Constant Quality Improvement in PD has made possible to know the current situation of our unit and to raise some matters when it is necessary to insist to get a better quality in our assistance.