Experience Managing Adult Patients on Continuous Ambulatory Peritoneal Dialysis in Bangladesh (original) (raw)
Related papers
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
The status of, and obstacles to, continuous ambulatory peritoneal dialysis in Thailand
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2008
The prevalence of dialysis in Thailand is 282 per million population, and utilization of peritoneal dialysis (PD) is only 4.6% of the utilization of hemodialysis (HD). The causes of low PD utilization include a relatively higher cost of PD care, especially from the patient's perspective; less incentive for PD care on the part of health care providers and hospitals; fewer continuing medical and nursing education programs in PD; unavailability of certified PD nurses; lack of confidence in the quality of PD care; fewer offers of PD as a renal replacement therapy option during pre-dialysis counseling; fear of peritonitis on the part of the patient, and also fear of burdening family members; a less stringent government policy regarding the "PD first" strategy. To increase PD utilization. mandatory strategies are lower PD cost, make all PD equipment reimbursable, launch a stringent "PD first" policy, provide incentives to health care providers and hospitals, and im...
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.
Chronic kidney disease is a major public health problem that continues to show an unrelenting global increase in prevalence. The prevalence of chronic kidney disease has been predicted to grow the fastest in low-to middle-income countries (LMICs). There is evidence that people living in LMICs have the highest need for renal replacement therapy (RRT) despite the lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, much infrastructure, or need for dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. However, CAPD is scarcely available in many LMICs, and even where available, there are several hurdles to be confronted regarding patient selection for this modality. High cost of CAPD due to unavailability of fluids, low patient education and motivation, low remuneration for nephrologists, lack of expertise/experience for catheter insertion and management of complications, presence of associated comorbid diseases, and various socio-demographic factors contribute significantly toward reduced patient selection for CAPD. Cost of CAPD fluids seems to be a major constraint given that many countries do not have the capacity to manufacture fluids but instead rely heavily on fluids imported from developed countries. There is need to invest in fluid manufacturing (either nationally or regionally) in LMICs to improve uptake of patients treated with CAPD. Workforce training and retraining will be necessary to ensure that there is coordination of CAPD programs and increase the use of protocols designed to improve CAPD outcomes such as insertion of catheters, treatment of peritonitis, and treatment of complications associated with CAPD. Training of nephrology workforce in CAPD will increase workforce experience and make CAPD a more acceptable RRT modality with improved outcomes.
Chronic Peritoneal Dialysis—A Single-Center Experience
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Objective In Saudi Arabia, experience with continuous ambulatory peritoneal dialysis (CAPD) as a renal replacement therapy is limited, and publications are scanty. The present study was undertaken to evaluate CAPD in the Saudi population. Patients and Methods All patients managed by CAPD from May 1993 to September 2002 were included in the study. Tenckhoff indwelling silicone-rubber double-cuff catheters were surgically implanted. Peritoneal dialysis (PD) was started 2 weeks after catheter insertion. Generally, 2-L exchanges 4 times daily were used. Our total of 91 PD patients included 50 men in the age range 13 – 80 years (mean: 48 ± 18 years), and 41 women in the age range 16 – 76 years (mean: 52 ± 18 years). Forty-nine patients performed dialysis by themselves; 42 patients needed a helper. Results Between April 2001 and September 2002, we noted, on average, 1 episode of peritonitis per 21 patient–months and 1 episode of exit-site infection per 24 patient–months. The most common c...
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.
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...
Peritoneal dialysis in developing countries
Contributions to nephrology, 2009
Peritoneal dialysis (PD) is acknowledged worldwide as a well-accepted form of renal replacement therapy (RRT) for end-stage renal disease (ESRD). Ideally, PD should be the preferred modality of RRT for ESRD in developing countries due to its many inherent advantages. Some of these are cost savings (especially if PD fluids are manufactured locally or in a neighboring country), superior rehabilitation and quality of life (QOL), home-based therapy even in rural settings, avoidance of hospital based treatment and the need for expensive machinery, and freedom from serious infections (hepatitis B and C). However, this is not the ground reality, due to certain preconceived notions of the health care givers and governmental agencies in these countries. With an inexplicable stagnation or decline of PD numbers in the developed world, the future of PD will depend on its popularization in Latin America and in Asia especially countries such as China and India, with a combined population of 2.5 b...
Opinion: Peritoneal Dialysis In Pakistan: An Insider’s View. State of Affairs and Planning?
Pakistan Journal of Kidney Diseases, 2021
Pakistan has an estimated population of 212 million while the incidence of end stage renal disease in Pakistan is 100 patients per million; hence approximately 22,000 patients require maintenance dialysis to sustain life in our country. Remarkably peritoneal dialysis (PD) as a form of maintenance renal replacement is utilized in less than one per cent of these patients. In the absence of a formal dialysis registry, we place the total number of chronic ambulatory peritoneal dialysis patients (CAPD) in Pakistan at approximately 76 excluding holiday patients who are visiting from abroad (*This figure was estimated by enquiring the total number of patients each PD units care in Pakistan. This figure was corroborated with the sole distributor of CAPD fluids in Pakistan.).