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Peritoneal Dialysis Use and Practice Patterns: An International Survey Study.
Yeoungjee Cho1, Aminu K Bello2, Adeera Levin3
1Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Metro South and Ipswich Nephrology and Transplant Services (MINTS), Princess Alexandra Hospital, Brisbane, Australia.
Summary
Global disparities in peritoneal dialysis (PD) access and quality are significant. This study highlights major gaps in PD availability, affordability, and outcome reporting, particularly in Africa and South Asia, impacting kidney failure patients worldwide.
Area of Science:
- Nephrology
- Global Health
- Dialysis Therapy
Background:
- Peritoneal dialysis (PD) is a vital treatment for kidney failure, used by approximately 11% of patients globally.
- Significant regional variations in PD utilization and practice patterns necessitate a comprehensive worldwide assessment.
Purpose of the Study:
- To investigate the global landscape of peritoneal dialysis (PD) use, availability, accessibility, and affordability.
- To examine the delivery of PD and the reporting of quality outcome measures across diverse countries.
Main Methods:
- A global cross-sectional survey was conducted involving stakeholders from 182 countries.
- Data were collected on PD use, availability, cost, delivery, and quality metrics, with responses received from 88% of countries.
Main Results:
- Peritoneal dialysis (PD) was unavailable in 19% of responding countries, with higher rates in Africa and low-income nations.
- Significant disparities were found in PD accessibility, affordability (patient copayments), and adequate exchange volumes.
- Quality outcome monitoring and reporting for PD were variable, with most countries not measuring patient-reported outcomes.
Conclusions:
- Substantial inter- and intraregional disparities exist in peritoneal dialysis (PD) provision and quality worldwide.
- The greatest deficits in PD availability, accessibility, affordability, and quality reporting were observed in Africa and South Asia.
- Addressing these disparities is crucial for equitable kidney failure management globally.
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