[Why and how to promote peritoneal dialysis?]

Area of Science:

• Nephrology
• Renal Replacement Therapy

Background:

• Peritoneal dialysis (PD) prevalence in France is notably low compared to other European countries, despite official guidelines promoting its use since 2008.
• Effective management of PD requires advancements in peritoneal catheter placement and comprehensive understanding of associated complications.

Purpose of the Study:

• To identify key factors and strategies for increasing the adoption and efficacy of peritoneal dialysis in France.
• To highlight the importance of biocompatible solutions and patient education in PD management.

Main Methods:

• Review of current practices and recommendations for peritoneal dialysis.
• Analysis of factors influencing PD adoption, including technical, clinical, and socioeconomic aspects.
• Discussion of optimal patient selection and educational strategies.

Main Results:

• Progress in peritoneal catheter techniques and complication management is crucial.
• Biocompatible solutions show promise in preserving the peritoneal membrane and reducing morbidity/mortality.
• Optimal candidates include young patients awaiting transplantation, elderly patients without malnutrition, and those with cardiac insufficiency.

Conclusions:

• Mandatory pre-end-stage renal disease education and objective information on both PD and hemodialysis are necessary.
• Addressing non-medical barriers, particularly financial ones, through economic incentives is vital for PD development.
• Enhanced training for nephrologists in PD is now available and essential.