Peritoneal Dialysis Use and Practice Patterns: An International Survey Study.
Am J Kidney Dis
; 77(3): 315-325, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-32800844
ABSTRACT
RATIONALE & OBJECTIVE:
Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. STUDYDESIGN:
A cross-sectional survey. SETTING &PARTICIPANTS:
Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018.OUTCOMES:
PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. ANALYTICALAPPROACH:
Descriptive statistics.RESULTS:
Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes.LIMITATIONS:
Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data.CONCLUSIONS:
Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia.Palavras-chave
Epidemiology; RRT modality; access to health care; affordability of health care; end-stage renal disease (ESRD); global survey; health care delivery; health care disparities; health policy; home dialysis; international differences; kidney failure; peritoneal dialysis (PD); renal replacement therapy (RRT)
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Padrões de Prática Médica
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Diálise Peritoneal
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Internacionalidade
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Acessibilidade aos Serviços de Saúde
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Falência Renal Crônica
Tipo de estudo:
Health_economic_evaluation
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Am J Kidney Dis
Ano de publicação:
2021
Tipo de documento:
Article