Factors affecting the use of peritoneal dialysis among the ESRD population in India: a single-center study (original) (raw)
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Journal of clinical and diagnostic research : JCDR, 2015
Hemodialysis (HD) and peritoneal dialysis (PD) are important renal replacement treatments in end stage renal disease (ESRD). There is paucity of data comparing outcomes and quality of life (QOL) between the two modalities in Indian scenario. We followed 60 End stage renal disease patients (30 CAPD and 30 Maintenance hemodialysis) for a period of one year. Patients were analysed and compared for complications, physical quality of life and psychological well being with a two part self reported questionnaire at baseline and subsequently at six and twelve months. For the physical component appropriate sections of the McMaster Health Index Questionnaire (MHIQ) and for psychological component Psychological General Well-Being Index (PGWB) developed by Dupey was applied. The number of males and females in both groups were comparable (p-value > 0.05).The prevalence of diabetes mellitus, coronary artery disease, obesity and ischaemic heart disease was comparable in both groups (p-value>...
Peritoneal dialysis in India: current status and challenges
2008
Abstract With its ambulatory nature and freedom from complicated and expensive technology, chronic peritoneal dialysis (PD) is the ideal renal replacement therapy for resource-poor India. Despite being available for more than 15 years, PD has been limited in its growth because of economic factors, inadequate government policies, nephrologist bias, and lack of adequate pre-dialysis care. The number of patients initiated on therapy has increased in recent years, but the number of early dropouts remains high.
Nonclinical Factors Associated with Treatment with Peritoneal Dialysis in Esrd Patients in Taiwan
Peritoneal Dialysis International, 2010
Objectives: Less than 10% of end-stage renal disease (ESRD) patients in Taiwan receive peritoneal dialysis (PD), which reveals the situation of underutilization of PD. We thus aimed to investigate factors associated with treatment with PD in ESRD patients in Taiwan. ♦♦ ♦♦ ♦ Patients: Patients that were 18 years of age or older and had been on dialysis for at least 3 months since 2001 were recruited and interviewed with a structured questionnaire. ♦♦ ♦♦ ♦ Results: 98 hemodialysis (HD) and 102 PD patients were recruited. In univariate analysis, age, sex, level of education, employment status, marital status, traffic time, family support, patient cognition, and receptivity were correlated with treatment with PD. Multivariate analysis showed that patients that were not married (p = 0.006), that spent more time traveling to the dialysis clinic (p = 0.006), that were not emergent at the start of dialysis (p = 0.003), and that had better family support (p = 0.045), a higher cognition of dialysis (p = 0.034), and stronger receptivity to dialysis (p < 0.001) were more likely to receive PD. ♦♦ ♦♦ ♦ Conclusions: We recommend patients follow the standard process to obtain more exhaustive information, consultation, and early referral. In addition, we suggest healthcare providers remind patients to take into account such nonclinical factors as family support and patient receptivity when they choose their dialysis modality.
Chronic peritoneal dialysis in South Asia - challenges and future
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Chronic peritoneal dialysis (PD), especially continuous ambulatory PD (CAPD), is being increasingly utilized in South Asian countries (population of 1.4 billion). There are divergent geopolitical and socioeconomic factors that influence the growth and expansion of CAPD in this region. The majority of the countries in South Asia are lacking in government healthcare system for reimbursing renal replacement therapy. The largest utilization of chronic PD is in India, with nearly 6500 patients on this treatment by the end of 2006. A large majority of patients are doing 2 L exchanges 3 times per day, using glucose-based dialysis solution manufactured in India. Chronic PD is not being utilized in Myanmar, Bhutan, or Seychelles. Affirmative action by the manufacturing industry, medical professionals, government policy makers, and nongovernmental organizations for reducing the cost of chronic PD will enable the growth and utilization of this life-saving therapy.
Predictors of Long-Term Survival on Peritoneal Dialysis in South India: A Multicenter Study
Peritoneal Dialysis International, 2010
Background Little is known about survival on peritoneal dialysis (PD) in Indian patients since the initiation of continuous ambulatory PD (CAPD) in India in 1991. Survival data from single centers with small numbers have been published. Objective A retrospective 4-center analysis for predictors of survival >3 years in south Indian chronic PD patients. Methods A total of 309 patients were trained during the observation period (from 1999 to 2004) and were analyzed in a multicenter study (4 centers), including 150 patients (male:female 109:41) that survived ≥ 3 years and 59 patients that did not survive ≥ 3 years (nonsurvivors; male: female 43:16) that were taken as controls. The patients were on chronic PD, predominantly CAPD, using double-bag disconnect systems. They were supervised by 4 nephrologists. Mean age in the nonsurvival group was 56.6 ± 10.6 years. In the survival group, mean age was 50.9 ± 14.9 years; there were 92 (62%) nondiabetics and 58 (38%) diabetics; the majority...
Journal of Dhaka Medical College, 2016
Continuous Ambulatory Peritoneal Dialysis (CAPD) is an established form of dialysis in Bangladesh now-a-days. It was a retrospective analysis, where we studied on 107 cases of CAPD patients in different specialized hospitals in Dhaka, Bangladesh. The aim of this study was to describe experience of CAPD in our setup and its impact on survival.Male and female ratio was 54:53.Mean age was 60±11.2years. Main causes of ESRD were diabetic nephropathy (58.9%).53.3% of patient prefered CAPD as a mode of renal replacement therapy to other modalities.32.7% patient suffered from peritonitis. Exit site infection occurred in 9.3%. Among non- infectious complications pain during dialysis(30.8%) was most common. Mean Blood urea was 19.15mg/dl; serum creatinine 633micromol/L.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 132-135
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Peritoneal dialysis (PD) penetration in India remains low despite the huge chronic kidney disease burden and unmet need for renal replacement therapy (RRT). In order to understand the socioeconomic reasons that govern patients' preference for hemodialysis (HD), we carried out an opinion survey among prevalent in-center HD patients at our institution using a multiple response questionnaire that was verbally administered to them at the dialysis facility by the investigators. Close to 80% were self-financed and 49.5% were on twice weekly HD. Despite the majority (95%) receiving RRT education from a nephrologist, 43.4% were not aware of PD as an RRT modality. The treating nephrologist's recommendation was the most important reason given for choosing HD (77.8%) and not choosing PD (69.7%). Other reasons for not choosing PD included lack of a dedicated caregiver or "clean area" at home (15.1%), fear of infection (15.1%), disruption of work (14.1%), and the high cost of P...
Incidence of end stage renal disease on renal replacement therapy in Nepal
Kathmandu University Medical Journal, 2010
Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives:The objective of this study is to fi nd out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients fi le, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profi le, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 + 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to fi nd out of cause of ESRD and to institute preventive measures.