Related Experiment Video
Updated: Oct 4, 2025
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
Peritoneal dialysis care during the COVID-19 pandemic, Thailand
Talerngsak Kanjanabuch1, Krit Pongpirul2
1Division of Nephrology, Department of Medicine and Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
The COVID-19 pandemic altered peritoneal dialysis care in Thailand, with reduced follow-ups and home visits. Nurses faced increased workloads, necessitating exploration of new care models for future pandemics.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted healthcare services, including chronic kidney disease management.
- Peritoneal dialysis (PD) is a crucial renal replacement therapy for chronic kidney disease (CKD) patients.
- Thailand provides free PD services, with 32,284 patients across 240 centers as of December 2020.
Purpose of the Study:
- To evaluate how PD centers in Thailand adapted their services during the COVID-19 pandemic.
- To identify changes in PD care provision, including patient training, procedures, and follow-up.
- To understand the impact on healthcare professionals, particularly PD nurses.
Main Methods:
- An online survey was distributed to medical directors and PD managers in Thailand on July 1, 2021.
- The survey assessed modifications in patient training, catheter insertion/removal, intravenous supplements, follow-up, home visits, and workload.
- Data were collected from 118 PD centers.
Main Results:
- Patient educational sessions were modified at 24.6% of centers.
- Catheter insertions continued at 71.9% of centers, but peritoneal equilibration tests were rarely performed as usual (19.7%).
- Most centers reduced outpatient follow-ups (51.7%) and home visits (66.9%), while PD nurses experienced increased workloads (62.7%) and assisted with COVID-19 patient care and vaccination.
Conclusions:
- Healthcare providers adapted clinical activities to mitigate COVID-19 risks for PD patients.
- The long-term consequences of these care alterations require further investigation.
- Exploring non-conventional PD care models and incentive mechanisms is crucial for pandemic preparedness.
Problem:
The coronavirus disease 2019 (COVID-19) pandemic could affect health service provision of less urgent interventions, such as peritoneal dialysis for chronic kidney disease patients.
Approach:
To assess how peritoneal dialysis centres in Thailand adapted their provision of care, we invited medical directors and peritoneal dialysis managers to respond to an online survey on 1 July 2021. We asked whether they had modified or deferred their training, catheter insertion or removal, intravenous supplements, follow-up and home visits, and workload.
Local Setting:
Patients needing dialysis receive peritoneal dialysis free of charge in Thailand. As of 31 December 2020, 240 peritoneal dialysis centres in Thailand have provided care to 32 284 patients.
Relevant Changes:
At 24.6% (29/118) of centres, educational sessions for patients were modified. Catheter insertion continued at 71.9% (82/114) of centres. Few facilities (19.7%; 23/117) continued to perform peritoneal equilibration tests as usual. On-site intravenous injections were mostly transferred to health centres close to the patients' homes. Most centres reduced their outpatient follow-up visits (51.7%; 61/118) and stopped visiting patients at home (66.9%; 79/118). Peritoneal dialysis nurses reported an increased workload at 62.7% (74/118) of centres, and in many instances (66.1%; 78/118) were providing nursing care to COVID-19 patients and administering COVID-19 vaccines.
Lessons Learnt:
Health-care providers altered clinical care activities to protect their patients from COVID-19. However, further evidence is needed on the consequences of such alteration in care. To prepare for future pandemics, actors need to explore nonconventional peritoneal dialysis care as well as financial and nonfinancial incentive mechanisms for such care.
Related Concept Videos
01:25Peritoneal Dialysis III: Nursing Management
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:30Peritoneal Dialysis I: Introduction and Procedure
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:25Hemodialysis III: Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care