Peritoneal catheter insertion: combating barriers through policy change

Area of Science:

• Nephrology
• Surgical Procedures
• Public Health Policy

Background:

• Home dialysis, particularly peritoneal dialysis (PD), is a vital option for kidney failure patients.
• The COVID-19 pandemic highlighted critical barriers to accessing PD catheter insertion, impacting patient survival.
• Timely access to PD catheter insertion procedures is essential for effective home dialysis therapy.

Purpose of the Study:

• To comprehensively analyze global PD catheter insertion procedures and identify access barriers.
• To assess the impact of the COVID-19 pandemic on PD catheter insertion capabilities and outcomes.
• To propose a roadmap of policy solutions to improve access to PD and home dialysis.

Main Methods:

• A global survey of institutions was conducted to gather data on regulatory frameworks, procedural barriers, and pandemic impacts.
• Analysis of current PD catheter insertion practices worldwide.
• Review of policy implications and potential solutions.

Main Results:

• Barriers to PD catheter insertion significantly limit home dialysis access, a critical issue exacerbated by the COVID-19 pandemic.
• Improving patient selection, insertion techniques, and multidisciplinary team collaboration enhances PD access.
• Global survey data reveals challenges in regulatory frameworks and pandemic-related disruptions.

Conclusions:

• Enhancing PD catheter insertion access requires optimizing patient selection, insertion techniques, and multidisciplinary care.
• Policy-level interventions, including increased awareness, enhanced training, and dedicated funding, are crucial for greater PD uptake.
• Strengthening the infrastructure and training for PD catheter insertion is vital to expand home dialysis options for kidney failure patients.