Peritoneal Dialysis in Italy: the 8th GPDP-SIN Census 2022 - 2nd Part: the Centers

Area of Science:

• Nephrology
• Renal Medicine
• Dialysis Technology

Background:

• The Italian Society of Nephrology conducted its 8th National Census (Cs-22) to assess Peritoneal Dialysis (PD) centers in Italy.
• Data from 227 non-pediatric centers using PD in 2022 were collected and analyzed.

Purpose of the Study:

• To characterize Italian Peritoneal Dialysis centers in 2022.
• To investigate resources, training, and home visit practices.
• To analyze the association between center size and PD outcomes.

Main Methods:

• Centers were categorized into quartiles based on the number of prevalent PD patients (as of 31/12/2022).
• Data on center size, personnel, training, and patient outcomes were collected.
• Key metrics included patient drop-out rates, peritonitis rates, and home visit frequency.

Main Results:

• Smaller PD programs (<9 patients) were associated with smaller center size, fewer dedicated staff, increased reliance on external training, and less frequent peritoneal permeability evaluations.
• These smaller centers also showed higher dropout rates to hemodialysis (HD), often due to patient choice or treatment-related issues.
• Larger PD programs (≥25 patients) reported lower peritonitis rates.
• Regular home visits were uncommon across most centers.

Conclusions:

• A significant association exists between the size of a Peritoneal Dialysis center's program and its available resources.
• Center size correlates with PD modality practices and patient outcomes, including peritonitis and dropout rates.
• Optimizing resources and potentially standardizing practices like home visits may improve PD patient care across different center sizes.