How peritoneal dialysis has developed in Vietnam.

In Vietnam, continuous ambulatory peritoneal dialysis (CAPD) with a straight line and one bag was first used in 1998. Because the complication rate, mainly as a result of catheter obstruction and peritonitis, was very high (50%), treatment was stopped after the first 10 cases. Use of the modality resumed only in 2001. However, because of skepticism and concern on both the part of physicians and patients about the effectiveness of peritoneal dialysis (PD) and about the infection risk, CAPD developed very slowly. Until late 2004, patient numbers were very limited, and there was only one PD unit in the entire country. Since then, CAPD using Y-set and two-bag system-plus routine omentectomy during catheter insertion and better patient selection and training in bag exchange-has resulted in much better outcomes with fewer complications, and the technique has been developing far faster. This success, together full insurance coverage of both dialysis and erythropoietin since 2005, has led to a steep rise in the number of patients on PD and the number of PD units. As a result, despite the initial difficulty, the number of PD patients increased to nearly 700 in just 3 years (2004 - 2007), while it took more than 20 years before more than 3000 patients were receiving hemodialysis. Automated PD and icodextrin are not yet available in Vietnam.