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Sustained Increase in Peritoneal Dialysis Prevalence through a Structured PD Initiation Service

Muhammad Masoom Javaid1,2,3, Behram Ali Khan4,2, Xi Er Emily Yeo4

  • 1Division of Nephrology, University Medicine Cluster, National University Hospital, Singapore mmjavaid@doctors.org.uk.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|September 7, 2018
PubMed

Insights

Implementing a structured peritoneal dialysis (PD) initiation service with a multidisciplinary team significantly expanded PD use. This coordinated care model improves patient selection, timely dialysis, and reduces complications, enhancing PD prevalence.

Area of Science:

  • Nephrology
  • Renal Medicine
  • Dialysis Therapy

Background:

  • Peritoneal dialysis (PD) prevalence can be limited by fragmented patient care pathways.
  • A dedicated, multidisciplinary approach to PD initiation is often lacking, leading to delays and suboptimal patient outcomes.

Purpose of the Study:

  • To describe the implementation and impact of a structured, multidisciplinary PD initiation service.
  • To evaluate the effectiveness of a coordinated care model in expanding PD program prevalence.

Main Methods:

  • Establishment of a dedicated PD initiation service involving nephrologists, interventionists, and PD nurses.
  • Integration of predialysis education, catheter insertion, dialysis initiation, and post-initiation follow-up.
  • Multidisciplinary team coordination for patient selection and issue resolution.

Main Results:

  • Significant expansion of the PD program observed after service implementation.
  • Improved patient selection criteria and minimized delays in PD catheter insertion.
  • Timely dialysis initiation, reduced urgent starts, and proactive management of early complications.

Conclusions:

  • A structured, multidisciplinary PD initiation service is effective in increasing PD prevalence.
  • Coordinated care enhances patient confidence and reduces technique failures.
  • This model alleviates barriers to PD adoption and improves patient management.

Keywords:
End-stage renal diseasedialysis initiationincidenceurgent start

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