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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.
Summary
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.
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